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患者女,52岁,1986年10月23日入院.患者近2年来自觉两下肢经常出现瘀斑,两季肋部针刺样隐痛,头晕乏力,近2月症状加重,伴上腹饱胀隐痛,至本院门诊发现肝脾肿大,血沉110mm/h,血清Ig定量:IgG 40.4g/L、IgA 1.98g/L、IgM 13.59g/L,蛋白电泳:γ为42.8%,γ区出现M蛋白带,而收入病房. 体检:贫血貌,浅表淋巴结无肿大,两下肢皮肤可见散在出血点和瘀斑.心肺听诊正常,腹软,肝剑下8cm,肋下7cm,脾肋下8cm,均质中,无压痛. 实验室检查:血红蛋白68g/L,白细胞4.3×10~9/L,血小板131×10~9/L.肝功能正常.血浆总蛋白91g/L,白球蛋白比为0.47∶1.乙肝三系阴性,磺溴酞钠2%,碱
The patient, 52 years old, was admitted to hospital on October 23, 1986. The patients had ecchymosis often manifested in the lower extremities in the past 2 years, acupuncture-like pain in the two seasons, and dizziness and fatigue. The symptoms were aggravated in recent 2 months with abdominal fullness and pain , To our hospital found hepatosplenomegaly, ESR 110mm / h, serum Ig quantitative: IgG 40.4g / L, IgA 1.98g / L, IgM 13.59g / L, protein electrophoresis: γ 42.8% Protein band, and income wards. Physical examination: anemia appearance, superficial lymph nodes without swelling, the two lower extremity skin scattered bleeding and ecchymosis. Cardiopulmonary auscultation normal, abdominal soft, liver sword 8cm, rib 7cm, spleen rib 8cm , Homogeneous, no tenderness.Laboratory examination: hemoglobin 68g / L, white blood cells 4.3 × 10 ~ 9 / L, platelets 131 × 10 ~ 9 / L. Normal liver function. Plasma total protein 91g / L, 0.47: 1. Hepatitis B tripartite negative, sodium 2% of sodium sulfochromate, alkali