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患者陆某,男,77岁,退休工人,口渴、多饮、多尿、消瘦20年,血糖最高达20mmol/L,20年前确诊为Ⅱ型糖尿病,长期服用甲磺丁脲0.5g,一日3次,血糖控制在6.5mmol/L左右。因发热、咳嗽、痰少色黄4天,体温37～39.9℃,呕咖啡样物1次,约300ml;黑便1次,约100g,糊状,于1994年4月2日入院。查体:神清,体温37℃,呼吸16次/min,血压16/8kPa,HR80次/分。中度贫血貌,消瘦,皮肤无瘀斑,浅表淋巴结未及,胸骨压痛(十),肝脾肋下未及,腹部未及包块。辅助检查:Hb64g/L,RBC2.0×10~12/L,WBC98×10~9/L,N86%,中、晚幼粒6%,L7%,M1%,BPC285×10~9/L,血糖12.4mmol/L,大便潜血(卅)尿常规:蛋白(+)、糖(+),染色体46XY,t(9;12),BM:增生极度活跃,粒红比例11:1,原粒0.5%,早幼粒12%,中幼粒28%,晚幼粒23.
Patients Lu Mou, male, 77 years old, retired workers, thirsty, polydipsia, polyuria, weight loss 20 years, blood glucose up to 20mmol / L, 20 years ago diagnosed with type II diabetes mellitus long-term use of 0.5g, 3 times a day, blood glucose control at 6.5mmol / L or so. Due to fever, cough, sputum less yellow 4 days, body temperature 37 ~ 39.9 ℃, vomit coffee sample 1, about 300ml; black stool 1, about 100g, pasty, in April 2, 1994 admission. Physical examination: Shen Qing, body temperature 37 ℃, breathing 16 times / min, blood pressure 16 / 8kPa, HR80 beats / min. Moderate anemia appearance, weight loss, skin ecchymosis, superficial lymph nodes, chest tenderness (X), liver and spleen ribs, and the abdomen and mass. Auxiliary examination: Hb64g / L, RBC2.0 × 10-12 / L, WBC98 × 10 ~ 9 / L, N86%, the late pellet 6%, L7%, M1%, BPC285 × 10 ~ 9 / L, Blood glucose 12.4mmol / L, stool occult blood (卅) urine routine: protein (+), sugar (+), chromosome 46XY, t (9; 12), BM: hyperproliferation is extremely active, %, Promyelocytic 12%, 28% of juvenile, late promyelocytic 23.