隐匿性迟发性皮肤型血卟啉病(LLCP)少见,并发心肌梗死(MI)尚未见报告。作者最近遇见1例LLCP并发MI,现报告如下。男患,54岁。从1983年开始患糖尿病。因近日出现右季肋部钝痛,全身无力、口干和口渴于1992年1月7日入院。体检:身高174cm、体重90kg脉搏76次/min、血压21.3/13.3kPa。在皮肤暴露部位(如颜面、颈部和手背等)有青铜色色素沉着,无病理性皮疹。肺正常,心音低钝、律整、无杂音。腹平软,肝大肋下5cm、表面光滑、弹性硬、有触痛,脾未触及。血化验:Hb126g/L、RBC3.6×1012/L、wBC5.0×109/L,血沉10mm/h;血糖15.2mmol/L, 总胆红质 20μmol/L、 AsT0.8μmol/LALTlμmol/L,总胆固醇7.4mmol/L,总蛋白78g/L,纤维蛋白原5.3g/L,凝血酶原指数87.9％,血清铁30.97μmol/L。尿化验:比重1.027,蛋白微量,白细胞和上皮细胞1～3个/视野,酮体(一)、尿糖0.5％。B超:示肝脏肿大。肝穿活检:示脂肪变性 There are no reports of occult delayed-onset cutaneous porphyria (LLCP) with concurrent myocardial infarction (MI). The authors recently met with a case of LLCP MI, are as follows. Male suffering, 54 years old. He has diabetes since 1983. Due to the recent dull right quarter rib pain, general weakness, dry mouth and thirst on January 7, 1992 admission. Physical examination: height 174cm, weight 90kg pulse 76 beats / min, blood pressure 21.3 / 13.3kPa. In the exposed parts of the skin (such as the face, neck and back of hand, etc.) Bronze pigmentation, no pathological rash. Normal lung, heart sound low blunt, law, no noise. Abdomen soft, large rib 5cm, smooth surface, elastic hard, tenderness, spleen not touched. Blood test: Hb126g / L, RBC 3.6 × 1012 / L, wBC5.0 × 109 / L, erythrocyte sedimentation rate 10mm / h; blood glucose 15.2mmol / L, total bilirubin 20μmol / L, AsT0.8μmol / LALTlμmol / Total cholesterol 7.4mmol / L, total protein 78g / L, fibrinogen 5.3g / L, prothrombin index 87.9%, serum iron 30.97μmol / L. Urinalysis: the proportion of 1.027, protein trace, white blood cells and epithelial cells 1 to 3 / field, ketone body (a), urine 0.5%. B super: shows the liver enlargement. Liver biopsy: shows steatosis