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患者 男,25岁。主因腰痛、泡沫尿3月余入院。患者2个月前受凉后腰痛,1周后出现双下肢浮肿,继延至全身。查尿蛋白(++++)。尿蛋白定量4.8g/d,血清白蛋白1.9g/L,球蛋白2.4g/L,以“肾病综合征”收入某院。6年前患“肝炎”。曾用强的松60mg/d,潘生丁150mg/d,肝素60mg/d皮下注射,并间断给予速尿及白蛋白静脉治疗,浮肿好转,尿蛋白仍在5.6g/d。用药4周后出现尿糖(++++),血糖7.2mmol/L,诊为“医源性糖尿病”。遂将强的松渐减,加用胰岛素,并给雷公藤糖浆30ml/d,病情无好转,收住我科。查体:血压16/12kPa。左下肺叩浊,呼吸音
Male patient, 25 years old. Main due to back pain, foam urine more than 3 months admitted to hospital. Patients with cold back pain after 2 months ago, two weeks after the lower extremity edema, following the extension to the body. Check urinary protein (++++). Proteinuria 4.8g / d, serum albumin 1.9g / L, globulin 2.4g / L, with “nephrotic syndrome” income of a hospital. Six years ago suffering from “hepatitis.” Have used prednisone 60mg / d, dipyridamole 150mg / d, heparin 60mg / d subcutaneous injection, and intermittent furosemide and albumin intravenous therapy, edema improves, urinary protein is still 5.6g / d. 4 weeks after treatment, urine sugar (++++), blood sugar 7.2mmol / L, diagnosed as “iatrogenic diabetes.” Then gradually decreased prednisone, plus insulin, and give Tripterygium syrup 30ml / d, no improvement in condition, admitted to our department. Physical examination: blood pressure 16 / 12kPa. Lower left lung tap turbid, breath sounds