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患者,男性,46岁。因浮肿、腹胀20天入院。体检:营养较差, 全身皮肤粘膜浮肿,以眼睑及双下肢最明显。腹部膨隆,无腹壁静脉怒张,肝脾不肿大,腹水征(+)。外周血查微丝蚴3次均(-)。尿蛋白(卅),颗粒管型(+),乳糜定性(-)。血清肌酐177μmol/L、尿素氮11.78mol/L。血清胆团醇18.6mmol/L、甘油三酯1.0mmol/L;密度脂蛋白73％,α脂蛋白25.5％、前脂蛋白13.5％,β脂蛋白61.7％;白蛋白22g/L、球蛋白26g/L,总胆红素3.4μmol/L,ZnTT3u,SGPT35u; AFP<20μg/L。血钾3mmol/L、钠140mmol/L、氯100mmol/L、(?)2mmol/L、磷1.2mmol/L。B超肝、脾正常。肾图示双侧分泌排泄延缓。腹水外观乳白色不透明,有核细胞0.06×10_9L,李凡他试验(-),比重1.012,蛋白1.7g/L,乳糜定性(+),苏丹Ⅲ
Patient, male, 46 years old. Due to edema, abdominal distension 20 days admission. Physical examination: poor nutrition, systemic skin mucosal edema, the most obvious eyelids and lower limbs. Abdominal bulge, no abdominal vein, hepatosplenomegaly, ascites (+). Peripheral blood microfilaria check 3 times (-). Urinary protein (卅), granular tube (+), chylomicron (-). Serum creatinine 177μmol / L, urea nitrogen 11.78mol / L. Serum cholalcohol 18.6mmol / L, triglyceride 1.0mmol / L; density lipoprotein 73%, alpha lipoprotein 25.5%, pre-lipoprotein 13.5%, beta lipoprotein 61.7%; albumin 22g / L, globulin 26g / L, total bilirubin 3.4μmol / L, ZnTT3u, SGPT35u; AFP <20μg / L. Serum potassium 3mmol / L, sodium 140mmol / L, chlorine 100mmol / L, (?) 2mmol / L, phosphorus 1.2mmol / L. B super liver, spleen normal. Kidney diagram bilateral secretion excretion delay. The appearance of ascites milky white opacity, nucleated cells 0.06 × 10_9L, Li where he test (-), the proportion of 1.012, protein 1.7g / L, qualitative chylous (+), Sudan Ⅲ