患者男,68岁,因在侧肢体活动障碍1周而入院.患者有高血压病史9年.体检:T36.8C,P 89次/min.,R 20次/min,Bp 23/13kPa;神志清,颈软,心肺未发现异常,腹平软,无压痛,双肾区无叩击痛;右侧肢体肌力Ⅰ级,病理性神经反射未引出.实验室检查:脑脊液无色透明,蛋白600mg/L,葡萄糖2.8mmol/L.白细胞15个/uL.头颅CT:左侧基底节有境界模糊的圆形低密度区.诊断:左侧脑梗塞、给予蝮蛇抗凝栓酶抗、青霉素预防感染及维生素B族、细胞色素C、能量合剂和脑活素治疗(奥地利依比威药厂生产).其中脑活素10mL加入5%葡萄糖250mL静脉点滴(20—25滴/min.qd).入院后第15天出现无痛性肉眼血尿,呈洗肉水样.且逐日加重;尿潜血(?).原高倍镜检红细胞(?).尿三杯试验为全程血尿,中段尿培养未发现致病菌,双肾、膀胱、输尿管B超正常.开始疑由蝮蛇抗栓酶所致血尿,立即停止该药,并给予卡巴克络(安咯血)、氨甲环酸(止血芳酸)治疗5d.血毫毫无改善,便停用脑活素,第2天肉眠血尿变淡,5天后尿潜血阴性,尿常 The patient, male, 68 years old, was admitted to the hospital for one week of hand movement disorder and had a 9-year history of hypertension. Physical examination: T36.8C, P 89 / min., R 20 / min, Bp 23/13 kPa; Clear, soft neck, no abnormal heart and lung, abdominal soft, no tenderness, no percussion pain in the renal area; right limb muscle grade Ⅰ, pathological reflex did not lead to laboratory tests: cerebrospinal fluid was colorless and transparent, protein 600mg / L, glucose 2.8mmol / L. WBC 15 / uL. Head CT: the left basal ganglia with a blurred area of ​​circular low density. Diagnosis: left cerebral infarction, given viper antithrombin enzyme resistance, penicillin Prevention of infection and vitamin B family, cytochrome C, energy mixture and brain activity of the treatment (Austria Viagra pharmaceutical production.) Including cerebrolysin 10mL added 5% glucose 250mL intravenous drip (20-25 drops / min.qd) .On the 15th day after admission, there was painless gross hematuria, which was washed with water sample and aggravate day by day. Urinary occult blood (?). The original high-power microscopy of red blood cells (?) .Three cups of urine test for the whole hematuria, Found that pathogens, kidneys, bladder, ureter B normal start suspected Viper antithrombotic hematuria, stop the drug immediately and give carbamacline (hemoptysis), tranexamic acid Blood aromatic acid) treatment 5d. Serum mmol no improvement, deactivates Cerebrolysin, day 2 sleep hematuria pale meat, 5 days negative occult blood, urine often