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男患,58岁,因发烧、面色苍黄一月,龈血、皮肤瘀斑一周,解柏油样便二次来诊.化验发现外周血像三系减少,疑“再障”收入院.患者一月半前因患慢性血吸虫病服吡喹酮,总剂量60mg/kg,每日三次,分三天服完.查体:T38.8℃,重度贫血貌,口腔粘膜、皮肤可见大小不等的出血点和瘀斑,肝肋下2cm 脾(-),颈强二横指.克氏征、布氏征可疑.Hb38g/L,WBC2×10~9/L,N0.15,L0.84,M0.01,PBC15×10~9/L,RC0.003.BT30秒.CT2分.肝肾功能正常,粪潜血(++).骨髓:增生减低.粒系占0.20,红系占0.15,成熟淋巴细胞占0.56,浆细胞0.04,网状细胞0.03,单核细胞0.02,计五张髓片未见到巨核细胞及血小板,造血岛主要为非造血细胞充填.经治疗无效自
Male, 58 years old, due to fever, looking pale yellow in January, gingival bleeding, skin ecchymosis week, asparagus solution will be the second visit to the clinic .Thin peripheral blood like three-line reduction, suspected “aplastic anemia” income hospital. Half a month before suffering from chronic schistosomiasis service praziquantel, the total dose of 60mg / kg, three times a day, three days to take service. Examination: T38.8 ℃, severe anemia appearance, oral mucosa, skin visible sizes Bleeding point and ecchymosis, 2cm spleen (-) under the hepatic ribs, strong transverse cross-neck of the neck, Kirschner’s sign and Buchner sign were suspicious.Hb38g / L, WBC2 × 10-9 / L, N0.15, L0.84, M0.01, PBC15 × 10 ~ 9 / L, RC0.003.BT30 seconds .CT2 points. Normal liver and kidney function, occult blood (++) .Bone marrow: reduced proliferation. Granulocyte accounted for 0.20, erythroid accounted for 0.15, mature Lymphocytes account for 0.56, plasma cells 0.04, reticulocytes 0.03, monocytes 0.02, five megakaryocytes and platelets were not seen, hematopoietic cells were mainly non-hematopoietic cells filled.