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患者,女,44岁。5年前体检时发现脾脏肋下1cm,血常规、肝功正常,脾大原因不明。4年前脾脏肋下2cm,3年前脾脏肋下4cm,查肝功正常,肝吸虫ELISA法(-),血吸虫ELISA法(-)。因无其他不适未引起注意,但发现脾脏呈进行性长大,18个月前脾肿大已达平脐。4年多来曾多次作血常规检查,Hb110～126g/L,WBC7.2～8.8×10~9/L,中性分叶0.65～0.71,中性杆状0.01～0.02,血小板160～298×10~9/L。骨髓涂片:骨髓增生明显活跃,G:E为1.3:1,粒系占0.435.其中早幼粒0.01.中幼粒0.05,晚幼粒0.05,杆状核0.105,分叶核0.15,酸性粒细胞0.05,碱性粒细胞0.02。粒细胞颗粒增粗,浆有少许空泡。肝功,蛋白电泳,免疫球蛋白定量,肿瘤筛选试验均正常。18个月前在某医院检查:肝脏肋下1cm,软,脾脏Ⅰ线12.5cm,Ⅱ线13cm,诊断为:肝硬化,门脉高压,巨脾。收入医院检查:血象正常,
Patient, female, 44 years old. 5 years ago when the physical examination found that the spleen rib 1cm, blood, normal liver function, splenomegaly for unknown reasons. 4 years ago, spleen ribs 2cm, spleen ribs 3 years ago, 4cm, check liver function normal, liver fluke ELISA (-), schistosome ELISA (-). Because no other discomfort did not attract attention, but found that the spleen was progressive growth, 18 months ago, splenomegaly flat navel. In the past 4 years, he had performed routine blood tests for many times. Hb110 ~ 126g / L, WBC7.2 ~ 8.8 × 10 ~ 9 / L, neutral leaves 0.65 ~ 0.71, neutral rod 0.01 ~ 0.02, platelets 160 ~ 298 × 10 ~ 9 / L. Bone marrow smear: Myeloid hyperplasia was obviously active, G: E was 1.3: 1, myoblast accounted for 0.435, of which, promyelocytic 0.01, mealy-myeloid 0.05, late promyelocytic 0.05, rod-shaped nucleus 0.105, Cell 0.05, basic granulocyte 0.02. Granulocyte granulation thick, pulp a little vacuole. Liver function, protein electrophoresis, immunoglobulin quantitative, tumor screening tests were normal. 18 months ago in a hospital examination: liver rib 1cm, soft, spleen I line 12.5cm, Ⅱ line 13cm, diagnosed as: cirrhosis, portal hypertension, splenomegaly. Income hospital examination: normal blood,