病史摘要 朱××,女,37岁,农民,1975年始有遇冷后手指阵发性发白变紫。次年起出现四肢大关节间歇性疼痛。1980年2月起又有二手指关节疼痛。同年8月有发热,前臂出现瘙痒性风疹块,单个皮损持续2～4天,此起彼伏;以后累及全身。服强的松后热退,关节痛消失,但皮损改善不明显。1981年3月起下肢反复发作多数小出血点。 体检:心肺(一)。肝肋下1.5cm,质软,无压痛;脾(一)。二手近端指间关节稍肿胀。两上肢和背有散在性水肿性红斑,有的边缘有一圈白晕,也有风团皮损。二小腿有多数散在高起皮面的瘀点和水肿性小红斑。 实验室检查:血红细胞420万/mm~3,血色素 Summary of medical history Zhu × ×, female, 37 years old, farmer, 1975, after the first cold paroxysmal parochial purple. The following year there have been intermittent limb pain joints. February 1980 there are second-hand finger joint pain. In August the same year there was fever, pruritus appeared in the forearm rubella block, a single lesion lasted 2 to 4 days, one after another; after the whole body involved. After serving strong loose heat, arthralgia disappeared, but the skin lesions improved not obvious. March 1981 since the lower extremities repeated episodes of most bleeding. Physical examination: cardiopulmonary (A). Liver ribs 1.5cm, soft, no tenderness; spleen (a). Used proximal interphalangeal joints slightly swollen. Two upper extremities and back with scattered edematous erythema, and some edge of a white halo halo, but also the wind group lesions. The second leg has the most scattered high from the petechiae and edematous erythema. Laboratory tests: red blood cells 4.2 million / mm ~ 3, hemoglobin