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[病例]男,33岁。10天前无诱因发热,体温39℃,伴头痛、腰痛,在当地医院诊断为流行性出血热,经对症治疗,体温降至正常,头痛、腰痛减轻,但出现乏力、食欲减退,转入我院。否认既往有水肿、高血压、血尿病史,其住地为肾综合征出血热(HFRS)高发区。查体:体温37℃,脉搏75/min,呼吸19/min,血压135/80mmHg。酒醉貌,心肺正常,腹软,肝脾未触及,腹水征阴性,双下肢无水肿,神经系统正常。血红蛋白91 g/L,白细胞 9.3 ×109/L,中性粒细胞 0.88,淋巴细胞 0.12,血小板206×109/L,尿蛋白(3+),隐血(3+),红细胞满视野/HP,血尿素氮(BUN)12.58 mmol/L,血肌酐(Cr)407μmol/L,血电解质正常,血糖 4.12 mmol/L,白蛋白/球蛋白=1.03,胆固醇 7.44mmol/L,血β2-微球蛋白 7.54 mg/L,尿β2-微球蛋白 0.63
[Case] Male, 33 years old. Ten days ago no incentive fever, body temperature 39 ℃, with headache, back pain, diagnosed as epidemic hemorrhagic fever in the local hospital, after symptomatic treatment, body temperature dropped to normal, headache, lumbago reduced, but there fatigue, loss of appetite, transferred to me hospital. Denied the previous edema, hypertension, history of hematuria, which lives in high incidence of hemorrhagic fever with renal syndrome (HFRS). Physical examination: body temperature 37 ℃, pulse 75 / min, breathing 19 / min, blood pressure 135 / 80mmHg. Drunken appearance, normal cardiopulmonary, abdominal soft, liver and spleen not touched, ascites sign negative, both lower extremity no edema, nervous system normal. Hemoglobin 91 g / L, white blood cells 9.3 × 109 / L, neutrophils 0.88, lymphocytes 0.12, platelets 206 × 109 / L, urinary protein (3+), occult blood (3+) BUN 12.58 mmol / L, serum creatinine 407 μmol / L, normal blood electrolyte, blood glucose 4.12 mmol / L, albumin / globulin = 1.03, cholesterol 7.44 mmol / L, blood β2-microglobulin 7.54 mg / L, urine β2-microglobulin 0.63