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作者报告一例82岁妇女,因患脑干局部贫血,间有暂时性意识丧失引起大小便失禁数月而住院治疗.以往有心肌梗塞的病史并10年前因为癌瘤做了乙状结肠前切除术.住院期间因轻度的心力衰竭间歇地用过洋地黄、安替舒通、氢氟甲噻嗪治疗.三个多月来,主诉二腿有日益加重的瘙痒和皮疹,呈融合性红斑伴剥蚀和苔藓化,少数扩展到二前臂和手背以及大腿、膝部和股内侧.并有精神抑郁,举步困难.化验结果:血色素、红细胞指数、白细胞计数、血清B_(12)、红细胞叶酸盐、血糖、血尿素、电解质、钙、磷、镁、血蛋白、蛋白电泳、肝功能、木糖吸收试验都在正常范围;铁和总铁结合力略低,上午10时(不禁食)血浆锌浓度是6.7μmol/l(正常范围是11.4～18.4μmol/l);胸部X线检查及钡灌肠正常.做锌负荷试验进一步检查,在禁食时给予大剂量的硫酸
The authors report a 82-year-old woman hospitalized for a few months with incontinence due to temporary loss of consciousness in a brainstem region, a past history of myocardial infarction and a sigmoid anterior resection of the tumor 10 years ago. During hospitalization due to mild intermittent heart failure with digitalis, amphetamine, hydroflumethiazide treatment more than three months, the chief complaint of the legs have an increasing pruritus and rash, was mergered with erythema with erosion And moss, a few extended to the second forearm and back of the hand and the thigh, knee and the inside of the hip, and depression, difficulty walking.Examination results: hemoglobin, erythrocyte index, white blood cell count, serum B 12, erythrocyte folate, Blood glucose, blood urea, electrolytes, calcium, phosphorus, magnesium, blood protein, protein electrophoresis, liver function, xylose absorption test are in the normal range; iron and total iron binding capacity is slightly lower at 10 o’clock (not fasting) plasma zinc The concentration was 6.7μmol / l (normal range was 11.4 ~ 18.4μmol / l); chest X-ray examination and barium enema normal.Do zinc load test for further examination, given a large dose of fasting sulfuric acid