患者男,25岁,反复颜面及下肢浮肿四年、加重伴腹胀四天。一年前曾住院诊为肾病综合征,给予强的松治疗,病情好转出院。四天前浮肿复发,伴腹胀尿少,日尿量约600ml,再次住院。查体:脸部轻度浮肿,心肺无异常,腹部膨隆,肝脾未触及,腹水征阳性,双下肢中度凹陷性浮肿。尿蛋白(十+++),红细胞3/HP、透明管型(+)、尿糖阴性。24小时尿蛋白4.9克,血浆总蛋白36克 Male patient, 25 years old, repeated facial and lower extremity edema for four years, increased with abdominal distension for four days. A year ago was hospitalized for nephrotic syndrome, given prednisone treatment, the condition improved discharge. Edema recurrence four days ago, with abdominal distension less urine, urine output of about 600ml, again hospitalized. Examination: mild swelling of the face, no abnormal heart and lungs, bulging abdomen, liver and spleen not touched, positive signs of ascites, moderately depressed lower extremity edema. Urinary protein (ten +++), erythrocyte 3 / HP, clear tube (+), urine negative. 24 hours urinary protein 4.9 grams, 36 grams of plasma total protein