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患儿男、12岁、青海籍。患儿从入院14天前开始间断发烧、关节痛,继而双下肢皮肤出现紫癜。并渐延至全身,出现少尿、腹痛、黑便住院。入院后检查体温37.3℃,脉博132次/分,血压110/70mmHg。一般状况差,精神萎靡,面色灰,口周发绀、烦躁、呼吸急促,全身有大小不等紫红色或紫黑色出血点,指斥不褪,部分中心坏死。以颜面腹部及双下肢伸侧、膝、踝关节处最多。全身浮肿,咽稍红,二肺密集水泡音,心音有力,律齐,心尖区Ⅰ级收缩期杂音,无心包摩擦音。腹稍胀、软、全腹有中度斥痛,无反跳痛。肝肋下1.5cm,质软,脾来及,肠鸣音减弱。神经系统未发现异常。外周血像Hb10.5克％,白血球12800,中性30％,淋巴70％,血小板5.6万。尿蛋白+++,尿镜检红细胞+,白细胞++,颗粒管型++,细胞管型少。BUN67.2mg％,血钾4.02mEq/L,钠117mEg/L氯95mEg/L,CO_2CP37.7体积％。血气,分析PH7.467,CO_2分压30.9mmHg,AB22.2mEg/L,BE
Children male, 12 years old, Qinghai membership. Children admitted to hospital 14 days before the onset of intermittent fever, joint pain, and then purpura on both lower extremity skin. And gradually extended to the whole body, there oliguria, abdominal pain, black will be hospitalized. After admission, check body temperature 37.3 ℃, pulse Bo 132 times / min, blood pressure 110 / 70mmHg. Poor general condition, apathetic, gray, mouth cyanosis, irritability, shortness of breath, body size ranging from purple or purple black bleeding point, denouncing does not fade, part of the center of necrosis. To the facial abdomen and lower limb extensor side, knee, ankle at most. Whole body edema, throat slightly red, densely popliteal sounds of the lungs, powerful heart sounds, law Qi, Ⅰ grade apex systolic murmur, heartless package friction sound. The abdomen slightly swollen, soft, full belly with moderate pain, no rebound pain. Liver ribs 1.5cm, soft, spleen and bowel sounds weakened. Nervous system found no abnormalities. Peripheral blood like Hb10.5 g%, white blood cells 12800, 30% neutral, lymphatic 70%, platelets 56000. Urine protein +++, urinalysis of red blood cells +, white blood cells ++, granular tube ++, cell tube less. 67.2 mg% of BUN, 4.02 mEq / L of potassium, 117 mEg / L of sodium 95 mEg / L of sodium and 37.7% by volume of CO 2 CP. Blood gas, analysis PH7.467, CO_2 partial pressure 30.9mmHg, AB22.2mEg / L, BE