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1 病例介绍 患者,女,47岁,1993年3月10日入院。1月前因受凉后出现头晕、纳差、腹痛、心慌、胸痛胸闷,于10天前出现下肢及颜面部水肿、少尿等症状,在当地诊治服药疗效不佳,逐来我院治疗。体检:T39℃,P100次/分,R22次/分,BP18/10 kPa,贫血貌,全身皮肤粘膜均有散在陈旧性出血点(斑),以下肢为多,并互相融合成片状、淋巴结不肿大胸骨压痛明显,肝脾未触及。实验室检查:HB 35g/L,WBC 12.5×10~9/L,BPC 35×10~9/L。嗜碱性早幼粒细胞0.07,嗜碱性中幼粒细胞0.23,嗜碱性晚幼粒细胞0.03,嗜碱性杆状粒细胞0.02。原始粒细胞0.06,早幼粒0.05,中幼粒0.04,杆状0.03,分叶0.03,淋巴细胞0.44。骨髓象:有核细胞增生极度活跃,粒系统占0.87,原粒+早幼粒占0.60,嗜碱性粒细胞
1 case description Patient, female, 47 years old, March 10, 1993 admission. 1 month ago due to cold after dizziness, anorexia, abdominal pain, palpitation, chest pain chest tightness, lower extremities and facial facial edema, oliguria and other symptoms appear 10 days ago, poor efficacy in the local diagnosis and treatment, came to our hospital. Physical examination: T39 ℃, P100 beats / min, R22 beats / min, BP18 / 10 kPa, anemia appearance, the whole body skin and mucous membranes are scattered in the old bleeding spots (spots), to the lower limbs and more, and each other into a patch, lymph nodes No swelling of the sternal tenderness, liver and spleen not touched. Laboratory tests: HB 35g / L, WBC 12.5 × 10 ~ 9 / L, BPC 35 × 10 ~ 9 / L. Basophilic promyelocytic 0.07, basophilic myeloblasts 0.23, basophilic late promyelocytic 0.03, basophilic rod-like granulocytes 0.02. 0.06 primordial granulocytes, 0.05 promyelocytic, 0.04 medium progenitor, 0.03 rod, 0.03 leaflet, and 0.44 lymphocytes. Bone marrow: nucleated cell hyperplasia is extremely active, accounted for 0.87 granule system, primordium + promyelocytic accounted for 0.60, basophils