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女,12岁。1992年8月查肝功正常,HBsAg(-),遂上臂三角肌皮下注射乙肝疫苗(疫苗为卫生部兰州生物制品研究所出品,批号92069)10μg。6d后突发恶心、呕吐、腹胀,伴发热、纳差、困倦。既往无药物过敏及肝炎接触史。查体:体温38℃。脉搏98/min,呼吸20/min,血压12.7/8.62kPa。皮肤巩膜黄染,表浅淋巴结不大,全身可见散在的直径约2mm大小的圆形红点,指压不退色,未高出皮肤,心肺听诊正常,肝肋下1.5cm,剑突下2cm,质软、边锐,有轻度压痛,脾不大,胆囊未触及。肝功能化验:麝浊9U,胆红素43.0mmol/L,ALT3420nmol.s~(-1)/L(正常值<700nmol·s~(-2)/L);HBV标志及HCV、HEV均(-);血常规化验:血红蛋白120g/L、白细胞8.9×10~9/L,分类:中性粒细胞0.61、淋巴细胞0.32、单核细胞0.02、嗜酸粒细胞0.05;尿8A(尿8项检查):pH6.0,胆红素(+)、0.5mg/dl,尿胆元(URO)(+)、3mg/dl,余均(-);血糖4.3mmol/L,BUN6.8mmol/L。西药给予肝太乐、维生素C、B_6等,
Female, 12 years old. August 1992 check normal liver function, HBsAg (-), then upper arm deltoid muscle injection of hepatitis B vaccine (vaccine for the Ministry of Health Lanzhou Institute of Biological Products, lot number 92069) 10μg. Sudden nausea after 6d, vomiting, bloating, fever, anorexia, sleepy. Past drug allergy and hepatitis history of exposure. Physical examination: body temperature 38 ℃. Pulse 98 / min, breathing 20 / min, blood pressure 12.7 / 8.62kPa. Skin sclera yellow dyed, superficial lymph nodes is not large, scattered around the body of the diameter of about 2mm in size circular red dot, finger pressure does not fade, not higher than the skin, cardiopulmonary auscultation normal, liver ribs 1.5cm, xiphoid 2cm, Soft, while sharp, mild tenderness, spleen, gallbladder not touched. Hepatic function test: Hemou turbidity 9U, bilirubin 43.0mmol / L, ALT3420nmol.s / (-1) / L (normal value <700nmol s -2 / L); HBV markers and HCV, HEV were -); blood tests: hemoglobin 120g / L, white blood cells 8.9 × 10 ~ 9 / L, classification: neutrophils 0.61, lymphocytes 0.32, monocytes 0.02, eosinophils 0.05; (+), 3mg / dl, the average (-); blood glucose 4.3mmol / L, BUN6.8mmol / L . Western medicine given liver too music, vitamin C, B_6, etc.,