论文部分内容阅读
(病例见本刊2012年第8期彩页)初步诊断及鉴别诊断:本例患儿主要表现为水肿、低蛋白血症。因此应该考虑:(1)膳食中摄入不足;(2)消化吸收不良;(3)合成障碍:如严重肝病;(4)丢失过多:肾脏、肠道等。根据病史、体检及相关辅助检查,前3个原因基本不甚支持,尿常规正常也不支持肾脏丢失。重点需要注意肠道丢失,如小肠淋巴管扩张症、过敏性胃肠病、IBD等。故首选应该检查:免疫球蛋白、淋巴细胞分类、小肠淋巴管
(See the case of 2012 cases 8 color pages) Preliminary diagnosis and differential diagnosis: This case of children with mainly edema, hypoproteinemia. Therefore, we should consider: (1) inadequate intake of diet; (2) poor digestion and absorption; (3) synthetic disorders such as severe liver disease; (4) excessive loss: kidney, intestine and so on. According to medical history, physical examination and related auxiliary examination, the first three reasons are not supported, and normal urine does not support kidney loss. Focus on the need to pay attention to intestinal loss, such as intestinal lymphangiectasis, allergic gastrointestinal disease, IBD and so on. Therefore, the preferred should check: immunoglobulin, lymphocyte classification, intestinal lymphatic vessels