1 病例报告患者男,38岁。因头痛8个月,加重7天于1999—04—28入院。查体:神志清,表情淡漠,应答切题。皮肤粘膜红紫,面颊、唇、舌、耳、鼻尖,四肢末端(指、趾及大小鱼际)尤甚,眼结合膜显著充血。双眼视力下降,脾脏中度增大。神经系统检查:四肢肌张力增加,肌力Ⅳ级,肌腱反射亢进,病理反射未引出。眼底检查:双侧视乳头水肿。头颅CT平扫:脑室系统明显扩张,脑组织受压,脑实质密度均匀,脑沟回无增宽,腰穿脑脊液压力37cmH_2O,压力试验阴性,因高度怀疑脑积水与真性红细胞增多症有关,遂行以下实验室检查:①~(51)Cr标记红细胞法测定红细胞容量,增加为40ml/kg,而血浆容量正常。⑦血细胞分析:红细胞7.34×10~(12)/L,血红蛋白181g/L,红细胞比容0.60;白细胞13.2×10~9/L;血小板3.8×10~(11)/L;③粒细胞碱性磷酸酶活性显著增高。④血气分 1 case report patient male, 38 years old. 8 months due to headache, increased 7 days in 1999-04-28 admission. Examination: Consciousness, apathy, answer questions. Skin mucosa purple, cheeks, lips, tongue, ears, nose, extremities (fingers, toes and the size of the occasion) especially eye conjunctiva significant congestion. Binocular vision decreased moderately increased spleen. Neurological examination: limb muscle tone increased, muscle strength grade IV, tendon hyperreflexia, pathological reflex did not lead. Fundus examination: bilateral papilledema. Cranial CT scan: ventricular system was significantly expanded, brain tissue compression, brain parenchyma density, no widening sulci, lumbar puncture cerebrospinal fluid pressure 37cmH2O, negative pressure test, due to a high degree of suspicion of hydrocephalus and polycythemia vera, Carry out the following laboratory tests: ① ~ (51) Cr labeled red blood cell assay erythrocyte capacity, increased to 40ml / kg, while the plasma volume is normal. ⑦ Hematology analysis: RBC 7.34 × 10-12 / L, hemoglobin 181g / L, hematocrit 0.60; WBC 13.2 × 10-9 / L; platelet 3.8 × 10-11 / L; Phosphatase activity was significantly increased. ④ blood points