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【病例简介】男,73岁。主因间断腹胀、低热3月,加重1周入院。患者于2014年11月下旬无明显诱因出现发热,体温波动在37~38℃,以午后为重,不伴咳嗽、咳痰等症状,在当地给予抗感染治疗后体温控制不佳,并出现腹胀,于2015年1月13日就诊于北京某权威肝病专科医院,化验肝功能:丙氨酸转氨酶49 U/L、天门冬氨酸转氨酶76 U/L、白蛋白32 g/L、总胆红素正常;病原学检查、自身抗体检查均阴性;彩超提示:肝实质弥漫性损害、腹水;核磁共振提示:肝脏形态异常,不除外肝硬化,脾稍大,腹水;胃镜检查未见食道、胃底静脉曲张;腹水常规检查提示:细胞总数423×10~6/L,白细胞223×10~6/L,淋巴细胞0.93、中性粒细胞0.05。结合影像学检查提示有肝硬化改变,腹水,白蛋白下降,腹水中细胞数升高,诊断为隐源性肝硬化,发
[Case description] Male, 73 years old. Mainly due to intermittent bloating, fever in March, increased 1 week admission. Patients in late November 2014 no obvious incentive to fever, body temperature fluctuations in the 37 ~ 38 ℃, no heavy afternoon, without cough, sputum and other symptoms, the local anti-infective treatment after giving poor body temperature control and bloating , On January 13, 2015, he was treated at an authority liver disease hospital in Beijing to test liver function: alanine aminotransferase 49 U / L, aspartate aminotransferase 76 U / L, albumin 32 g / L, total bilirubin Normal; etiological examination, autoantibodies were negative; color Doppler prompts: diffuse damage to the liver, ascites; nuclear magnetic resonance prompt: abnormal liver morphology, spleen slightly larger, ascites; gastroscopy no esophagus, stomach Varicose veins; ascites routine examination tips: the total number of cells 423 × 10 ~ 6 / L, white blood cells 223 × 10 ~ 6 / L, lymphocytes 0.93, neutrophils 0.05. Combined with imaging studies suggest changes in liver cirrhosis, ascites, albumin decreased, the number of cells in the ascites increased diagnosis of cryptogenic cirrhosis, hair