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患者,男,42岁。因四肢皮下硬肿3年,牙龈出血1个月,于1997年3月入院。患者于1994年2月无诱因出现右踝关节处皮下硬肿,关节活动轻度受限。之后,双膝关节及其远端肢体相继出现皮下硬肿,受累关节屈伸障碍。1997年2月牙龈少量出血,当时外周血全血细胞减少,抗链球菌溶血素“O”滴度为200IU,血沉130mm/1h,肌电图示轻度肌源性损害。同年3月牙龈仍有少量出血,伴明显乏力,外周血全血细胞减少,嗜酸粒细胞计数0.011×10~9/L。骨髓检查示骨髓增生不良,粒系增生不良,以分叶核细胞为主,偶见分叶过多现象,余各阶段细胞少见;红系增生不良,成熟红细胞
Patient, male, 42 years old. Three months of subcutaneous hard swelling, bleeding gums for one month, admitted to hospital in March 1997. In February 1994, the patient had a subcutaneous hard swelling of the right ankle joint with no incentive, and mildly limited joint activity. Later, the double knee joints and their distal limbs developed subcutaneous hard swelling and affected joint flexion and extension. In February 1997, a small amount of bleeding occurred in the gums. At that time, peripheral blood cells decreased, anti-streptolysin “O” titer was 200IU, and erythrocyte sedimentation rate was 130mm/1h. Myoelectricity showed mild myogenic damage. In March of the same year, there was still a small amount of bleeding in the gums with obvious weakness. Peripheral blood cells decreased and the eosinophil count was 0.011×10-9/L. Bone marrow examination showed poor myelodysplasia, poor granulocyte proliferation, mainly in lobulated nucleus cells, and occasionally excessive leaf segmentation. Cells were rare in other stages; poor erythroid hyperplasia and mature red blood cells.