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例1 男,67岁.因胃溃疡在院外服甲氰咪胍0.2g,3次/d.服药10天后出现乏力,鼻衄,发热,来我院诊治.查体:T 38.7C,P92次/分,BP 13/7kPa,面色苍白,皮肤可见散在瘀斑,肝脾不肿大,胸骨无压痛.血象:Hb50g/L,RBC2.1×10~(12)/L,WBC2.6×10~9/L,N0.70,L0.30,PC70×10~9/L.大便隐血(一).网织红计数0.01.疑为“再生障碍性贫血”,于1987年5月10日收入病房.做骨髓穿刺示:骨髓有核细胞增生低减,粒细胞增生低减,可见中毒颗粒,伴成熟障碍.红系增生低减,形态无畸形,成熟红细胞大致正常.淋巴细胞占0.40.全片见巨核细胞5个.血小板成簇不见,散在可见.停用甲氰咪胍,并积极抗感染,输血,应用升白细胞药治疗二周,自觉症状改善,体温正常.血象、髓象恢复正常出院.
Example 1 male, 67 years old due to gastric ulcer in the hospital with cimetidine 0.2g, 3 times / d. 10 days after taking the medication appeared fatigue, epistaxis, fever, to our hospital for diagnosis and treatment. Examination: T 38.7C, P92 / Min, BP 13 / 7kPa, pale, the skin scattered scattered ecchymosis, liver and spleen is not enlarged, sternal no tenderness. Blood: Hb50g / L, RBC2.1 × 10-12 / L, WBC2.6 × 10 ~ 9 / L, N0.70, L0.30, PC70 × 10 ~ 9 / L. Stool occult blood (a). Reticulocyte count 0.01. Suspected to be “aplastic anemia”, on May 10, 1987 income Ward do bone marrow puncture said: bone marrow cells decreased hyperplasia, granulocytopenia decreased, showing poisoning particles, with a mature barrier. Red hyperplasia reduction, no deformity morphology, mature erythrocytes generally normal lymphocytes accounted for 0.40. See megakaryocytes see 5. Platelets disappear, scattered visible. Disable cimetidine, and active anti-infection, blood transfusion, application of leukocyte drug treatment for two weeks, improve symptoms, body temperature normal. Blood, medulla returned to normal Discharged.