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李某,男.21岁,因全身起紫癜3天,于1988年8月4日收入院,患者入院前3天因腰腿痛口服消炎痛、感冒胶囊等药、治疗后全身起淤斑,伴鼻衄牙龌出血,腹痛。体检:T36.9℃,P100次/分,BP12/6.7kpa,全身可见散在大小不等淤斑淤点,以双下肢为重,表浅淋巴结不肿大,齿龈渗血,心肺正常,胸骨无压痛,肝脾未触及,剑突下及下腹部压痛。实验室检查:Hb110g/L,WBC4.4×10~9/L,N52%,L44%,E 2%,BPC25×10~9/L,RCI.8%;尿蛋白阴性,Rous 试验阴性。骨髓增生活跃,粒:红=0.84 :1,粒系增生活跃,原粒1.5%,早幼粒3%,中幼粒4.5%,晚幼粒3%,杆状核2%,分叶核30%,形态大致正常。红系增生活跃,各期均见,中幼红细胞比值增高(占30%),部分细胞核浆发育失衡,未见巨幼样及类巨幼样变;幼淋0.5%,成熟淋巴6.5%;巨核细胞全片1.5cm×3cm 3个,无产板巨,血小板未见中性粒细胞硷性磷酸酶积分48分。诊断为获得性低巨核细
Lee, male .21 years old, due to systemic purpura for 3 days, on August 4, 1988 income hospital, 3 days before admission due to low back pain, oral indomethacin, cold capsules and other drugs, systemic cholera after treatment, Accompanied by nose blepharoplasty bleeding, abdominal pain. Physical examination: T36.9 ℃, P100 beats / min, BP12 / 6.7kpa, the body can be seen ranging from scattered sizes of ecchymosis to both lower extremities, the superficial lymph nodes are not swollen, gingival bleeding, normal cardiopulmonary, sternal no Tenderness, liver and spleen not touched, xiphoid and lower abdomen tenderness. Laboratory tests: Hb110g / L, WBC4.4 × 10 ~ 9 / L, N52%, L44%, E 2%, BPC25 × 10 ~ 9 / L, RCI.8%; urine protein negative, Rous test negative. Myeloproliferative activity, granule: red = 0.84: 1, granulocyte hyperplasia active, 1.5% of the original grain, promyelocytic 3%, juvenile 4.5%, late juvenile 3%, rod 2%, lobulated 30 %, Morphology is generally normal. The erythroid hyperplasia was active in all stages, and the ratio of erythrocytes was increased (30%). Some of the cytoplasm nuclear cytoplasm was imbalanced. There were no giant juveniles and giant megaloblasts. The juvenile lymphocytes were 0.5% and the mature lymphomas 6.5% The whole cell 1.5cm × 3cm 3, no giant plate, no platelet neutrophil alkaline phosphatase score 48 points. Diagnosed as acquired low megakaryocyte