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患者 女,55岁。1996年8月22日入院。于入院前28天始发热、头痛、腰痛,在当地医院住院治疗。病程第4日出现低血压[8/5kPa(60/37.5mmHg)]。5病日出现少尿、尿中有膜状物,查出血热抗体IgM阳性。按出血热治疗。15病日进入多尿期(24小时尿量4000～6000ml),持续12天。22病日突然出现烦躁不安,双下肢青紫色瘀斑,伴高热(T39.1℃)、低血压[8/5kPa(60/37.5mmHg)],转入我院。既往患高血压4年、冠心病3年。入院时:T38.5℃,P110次/分,R20次/分,BP18/12kPa(135/90mmHg)。浅昏迷状,重度贫血貌、颜面水肿,结膜苍白,皮肤干燥、弹性差,瞳孔等大、等圆,光反应迟钝。颈稍抵抗。双肺呼吸音粗,有鼾鸣。腹水征(±),肠鸣音弱,四肢肌张力减低,膝腱反射减弱,病理反射阴性。实验室查:血常规Hb60g/L,RBC2.64×
Female patient, 55 years old. August 22, 1996 admission. 28 days before admission fever, headache, back pain, hospitalized in a local hospital. Hypotension [8 / 5kPa (60 / 37.5mmHg)] occurred on the fourth day of the course of disease. 5 days of oliguria appeared, there are membranous urine, found that hematological antibody IgM positive. According to hemorrhagic fever treatment. 15 days into polyuria (24-hour urine output 4000 ~ 6000ml) for 12 days. Suddenly 22 patients with irritable rest day, both lower extremity bruising ecchymosis, with high fever (T39.1 ℃), hypotension [8 / 5kPa (60 / 37.5mmHg]], transferred to our hospital. Previously suffering from hypertension for 4 years, 3 years of coronary heart disease. Admission: T38.5 ℃, P110 beats / min, R20 beats / min, BP18 / 12kPa (135 / 90mmHg). Shallow coma, severe anemia, facial edema, pale conjunctiva, dry skin, poor elasticity, pupils and other large, round, light reaction slow. Neck slightly resistant. Breath sounds thick lungs, snoring. Ascites sign (±), bowel sounds weak, lower extremity muscle tone, knee tendon reflexes, pathological reflex negative. Laboratory investigation: blood Hb60g / L, RBC2.64 ×