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患者,女性,45岁,工人。因不规则发热、头晕、乏力及皮肤紫癜2个月入院。患者于入院前2个月起不规则发热,时高时低,在外院经抗炎治疗仍发热不退,且渐感头昏、乏力,皮肤出现紫癜,用青霉素、链霉素及止血药无效而住院治疗。病前体健,无特殊嗜好,家族成员中无类似疾病。体格检查:体温38℃,血压14.67/10.67kPa(110/80mmHg),脉搏104次/分。重度贫血貌,颌下、颏下可触及数个蚕豆大小的淋巴结,质中,压痛(+),躯干、下肢皮肤可见散在性大小不等的出血点、紫癜、紫斑以至乌青块,无齿龈增生;胸骨邓击痛(++),肺呼吸音清晰,心率104次/分,律齐,心尖部可闻及Ⅱ级吹风样收缩期杂音;腹
Patient, female, 45 years old, worker. Due to irregular fever, dizziness, fatigue and skin purpura 2 months admitted. Patients 2 months before admission irregular fever, high and low hours, the anti-inflammatory treatment outside the hospital is still fever, and gradually feel dizzy, fatigue, skin purpura, with penicillin, streptomycin and hemostatic ineffective Hospitalization. Pre-illness health, no special hobbies, family members no similar diseases. Physical examination: body temperature 38 ℃, blood pressure 14.67 / 10.67kPa (110 / 80mmHg), pulse 104 beats / min. Severe anemia appearance, submandibular, submental reach of the number of broad bean-sized lymph nodes, quality, tenderness (+), trunk, lower extremity skin scattered spots of varying sizes can be seen bleeding, purpura, purple spots and even black blocks, Hyperplasia; sternum Deng pain (++), lung breath sounds clear, heart rate 104 beats / min, law Qi, apex can be heard and Ⅱ grade hair-style systolic murmur; abdomen