张某,男,21岁,农民。因乏力尿黄半月在当 地医院按急性黄疸型肝炎冶疗,病情加重转来我院。入院检查:一般情况较差;皮肤巩膜重度黄染,如桔黄色;左手臂见一枚蜘蛛痣,未见肝掌。心肺未见异常,腹胀气,无腹壁静脉曲张,腹水征(+),肝浊音界右锁骨中线第五肋间,下界肋下未触及,浊音区两个肋间,脾未触及;两下肢踝部以下有轻度凹陷性浮肿。B超检查:肝脏体积缩小,肝实质呈弥漫性损害。免疫学检查:抗-HAV-IgM(+);化验室检查, Zhang, male, 21 years old, farmer. Due to fatigue half a month urine in the local hospital according to acute jaundice hepatitis treatment, exacerbations transferred to our hospital. Admission examination: poor general condition; skin sclera severe yellow dye, such as orange; left arm see a spider mole, no liver palms. Heart and lung no abnormalities, abdominal distension, no abdominal varicose veins, signs of ascites (+), liver dullness right subclavian midline of the fifth intercostal, the lower limit of the ribs did not touch the dullness of the two intercostals, spleen not touched; lower extremity ankle Ministry of the following mild depression edema. B-ultrasound: the liver size is reduced, the liver parenchyma was diffuse damage. Immunological tests: anti-HAV-IgM (+); laboratory tests,