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患者男性,48岁,因“乙型肝炎病史10年,乏力、尿黄2个月,加重伴意识障碍1周”于2006年12月28日收入院。10年前体检时发现乙型肝炎表面抗原(HBsAg)阳性,当时肝功能正常,未予治疗。3年前检查乙型肝炎5项为 HBsAg阳性,乙型肝炎 E 抗原(HBeAg)阳性,乙型肝炎核心抗体(HBcAb)阳性;乙型肝炎病毒(HBV)-DNA10~5 copies/ml;开始服用拉米夫定(贺普丁)治疗(100 mg/d)。6个月前患者复查肝功能正常,HBV-DNA 阴性,遂停用贺普丁。2周前患者劳累后出现乏力,食欲减退,尿黄如浓茶,赴当地医院就诊,予以促肝细胞生长因子、胸腺肽、白蛋白等药物治疗,并行血浆置换3次,效果不佳,且逐渐出现意识障碍。遂转来我院,拟行肝移植治疗。入院时查体:生命体征平稳,神志淡漠,精神差,对时间、
Male patient, aged 48, was hospitalized on December 28, 2006 because of “a 10-year history of hepatitis B, weakness, dark urine for 2 months and aggravated by disturbance of consciousness for 1 week.” Hepatitis B surface antigen (HBsAg) was found 10 years ago on physical examination, at which time liver function was normal and was not treated. 3 years ago to check the hepatitis B 5 were HBsAg positive, hepatitis B E antigen (HBeAg) positive, hepatitis B core antibody (HBcAb) positive; Hepatitis B virus (HBV) -DNA10 ~ 5 copies / ml; Lamivudine (Lamivudine) treatment (100 mg / d). Six months ago, patients with normal liver function, HBV-DNA-negative, then disable the Lamting. 2 weeks before fatigue after fatigue, loss of appetite, dark yellow, such as tea, went to the local hospital for treatment of hepatocyte growth factor, thymosin, albumin and other drugs, parallel plasma exchange 3 times, ineffective, and gradually A disturbance of consciousness. Then transferred to our hospital, to be treated liver transplantation. Physical examination at admission: vital signs stable, apathetic, poor spirit, on time,