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患者女,21岁,因大量蛋白尿、浮肿、高血脂症确诊为原发性肾病综合征已三年,因反复发作于1981年6月再次入院。患者无高血压、心脏病及慢性肝炎史,过去住院均以强地松为主,用量30～40mg/日,每次治疗能获得暂时缓解,但当强地松减量到每日5～10mg 时,蛋白尿逐渐增多,浮肿再现。入院体检:T37℃、P100次,R20次、BP110/75。神志清,巩膜和皮肤未见黄染,无颈静脉怒张,颜面及两眼上下睑均见明显浮肿。心率100次,各瓣膜区未闻及病理性杂音。腹部无移动性浊音,肝肋下1.0cm,质软,脾未扪及。两下肢呈凹陷性浮肿。实验室检查:血红蛋白8.0g/d1,白细胞6000,中性粒细胞64%,淋巴细胞30%,单核细胞1%,酸性粒细胞3%,碱性粒细胞2%。尿常规:白细胞1～2,红细胞0～1,管型(-),24小时尿蛋白定量14.8g。肝功能检盘:SGPT、TTT、ZnTT、SB均在正常范围。血浆总蛋白4.8g,白蛋白2.8g,球蛋白2.0g。血脂检查:甘油三脂500mg%,β脂蛋白1000mg%,
The patient, 21 years old, was diagnosed with primary nephrotic syndrome for three years due to extensive proteinuria, edema and hyperlipidemia and was admitted again in June 1981 for recurrent episodes. Patients without hypertension, heart disease and history of chronic hepatitis, past hospitalized prednisone, the amount of 30 ~ 40mg / day, each treatment can be temporarily relieved, but when the reduction of prednisone daily 5 ~ 10mg When proteinuria gradually increased, edema reproduction. Admission examination: T37 ℃, P100 times, R20 times, BP110 / 75. Consciousness, sclera and skin no yellow dye, no jugular vein engorgement, facial and upper and lower eyelids were seen obvious edema. Heart rate 100 times, the valve area has not heard of pathological murmur. No dull abdominal movement, liver ribs 1.0cm, soft, the spleen is not palpable. Two lower limbs were depressed edema. Laboratory tests: hemoglobin 8.0g / d1, white blood cells 6000, 64% of neutrophils, lymphocytes 30%, monocytes 1%, 3% of neutrophils, 2% of neutrophils. Urine routine: white blood cells 1 to 2, 0 to 1 red blood cells, tubular (-), 24-hour urine protein 14.8g. Liver function test: SGPT, TTT, ZnTT, SB are in the normal range. Plasma total protein 4.8g, albumin 2.8g, globulin 2.0g. Blood lipids: triglyceride 500mg%, beta lipoprotein 1000mg%