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近几年,观察腹膜透析患者血清微量元素浓度的变化为铝增加,血清锌和铜正常、增加或减少。本文报道一例持续非卧床腹膜透析(CAPD)缺铜致严重粒细胞减少和输红细胞需要增加的患者。病例男,16岁,患胱氨酸病。因中性粒细胞减少就诊,每周3次腹膜透析已8年,完全肾衰已4年,每年输3次红细胞以维持血红蛋白大于7g/dl,常规治疗包括:苯巴比妥、维生素D、氢氧化铝凝胶、合成甲状腺素、叶酸、硫酸锌。既往无中性粒细胞减少病史。7个月前开始CAPD,4个月后验白细胞为1700/mm~3,中性粒细胞为9%,7个月后中性粒细胞绝对值为300/mm~3。此7个月中输入6个包装单位红细胞方维持血红蛋白在5g/dl以上。查体:
In recent years, observation of peritoneal dialysis patients serum concentrations of aluminum changes for the increase, serum zinc and copper normal, increase or decrease. This article reports a case of continuous ambulatory peritoneal dialysis (CAPD) lack of copper caused severe granulocytopenia and red blood cells need to increase in patients. Case male, 16 years old, suffering from cystopathy. Because of neutropenia, three times a week peritoneal dialysis has been 8 years, 4 years of complete renal failure, 3 times per year lose red blood cells to maintain hemoglobin greater than 7g / dl, routine treatment include: phenobarbital, vitamin D, Aluminum hydroxide gel, synthetic thyroxine, folic acid, zinc sulfate. No previous history of neutropenia. CAPD was started 7 months before, leukocyte count was 1700 / mm ~ 3 after 4 months, neutrophil count was 9%, and neutrophil absolute value was 300 / mm ~ 3 after 7 months. This 7 months, enter the 6 packaging units of red blood cells to maintain hemoglobin in 5g / dl above. Physical examination: