女,25岁。因乏力、恶心、呕吐、纳差、尿黄1周,查肝功能:黄疸指数(II)25U,丙氨酸转氨酶(ALT)>200U,HBsAg(-)。于1991年7月15日入院。发病前有在外就餐史,无肝炎接触史。体检:T36.8℃。皮肤无明显黄染,无皮疹、瘀点。巩膜黄染。心肺正常。腹平软,肝上界右锁骨中线第6肋间,肋下1.0cm,剑突下2.5cm,有压痛及叩击痛,脾肋下未触及。实验室检查:血红蛋白138g/L,白细胞5.2×10~9/L,中性粒细胞0.58,淋巴细胞0.40,单核细胞0.01,嗜酸粒细胞0.01。尿胆红质阳性,尿胆原1∶20(-)。肝功能:II22U,TTT10U、TFT(+),ALT>200U,甲型肝炎病毒抗体 Female, 25 years old. Liver function: jaundice index (II) 25U, alanine aminotransferase (ALT)> 200U, HBsAg (-), due to fatigue, nausea, vomiting, anorexia, urinary yellow for 1 week. July 15, 1991 admission. Before the onset of eating history, no history of exposure to hepatitis. Physical examination: T36.8 ℃. No obvious yellow skin dye, no rash, petechia. Sclera yellow dye. Cardiopulmonary normal. Abdomen soft, the upper right subclavian midline 6th intercostal rib, ribs 1.0cm, xiphoid 2.5cm, tenderness and percussion pain, spleen and ribs did not touch. Laboratory tests: hemoglobin 138g / L, white blood cells 5.2 × 10 ~ 9 / L, neutrophils 0.58, lymphocytes 0.40, monocytes 0.01, eosinophils 0.01. Urine bilirubin-positive, urobilinogen 1:20 (-). Liver function: II22U, TTT10U, TFT (+), ALT> 200U, Hepatitis A virus antibody