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患者,男性,27岁.发病前7年因患风湿性关节炎开始口服布洛芬片0.2g/次,3次/d,后加量至0.6g/次,3次/d.5年中,从未间断.发病前2年,该患者每逢阴雨天感觉腰腿疼痛加剧时即1次口服10余片.后出现头昏,乏力,心慌.进而不能正常工作,食欲减退,多汗,呕吐,经常性牙龈出血.入院前7天因劳累致头昏,乏力和心慌加重.同时发现上肢及颈部有散在出血点,呕吐1次.为咖啡样物质.体格检查:患者面色苍白,精神萎糜不振,胸部压痛,发热,体温38℃.实验室检查:血红蛋白84g/L;血小板63×10~9/l,白细胞数3.5×10~9/L,骨髓象早幼粒细胞>50%,临床诊断为急性粒细胞性的白血病.询问病史:患者无其它药物和特殊环境接触史.究其病因.与长期口服布洛芬片关系极大.
Patient, male, 27 years old. Began taking oral ibuprofen tablet 0.2g/time, 7 times before the onset of disease, 3 times/d, and then adding amount to 0.6g/time, 3 times/d.5 years , Has never been interrupted. Before the onset of the disease, the patient experienced more than 10 tablets orally once a day during the onset of rainy days when the lumbar and leg pain increased. Afterwards, dizziness, fatigue, palpitation, and then can not work properly, loss of appetite, excessive sweating, Vomiting, frequent bleeding gums, dizziness, fatigue and palpitation due to exertion 7 days before hospitalization. At the same time, it was found that the upper extremities and neck had scattered bleeding points and vomited once. It was a coffee-like substance. Physical Examination: The patient was pale, mental Malaise, chest tenderness, fever, body temperature 38 °C. Laboratory tests: hemoglobin 84g / L; platelets 63 × 10 ~ 9 / l, white blood cell count 3.5 × 10 ~ 9 / L, bone marrow-like promyelocytic> 50% Clinically diagnosed with acute myelogenous leukemia. Ask history: No history of exposure to other drugs and specific environmental conditions. The cause of the disease is of great relevance to long-term oral ibuprofen tablets.