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患者王××,男,37岁,住院号A67105。1981年6月由于外伤致双下肢截瘫,同年9月因发热(38℃)诊断为急性尿路感染,口服氯霉素,每天2.0g,约10天,并加用其他抗生素,15天后体温降至正常。1个月后逐渐出现心悸气短,下肢有凹陷性浮肿。1982年3月25日心悸气短加重并伴有头昏耳鸣入院。体检:重度贫血外观,消瘦面容,皮肤无黄染及出血点,浅表淋巴结不肿大。心肺正常,心率快,肝肋下1cm,肝区有叩痛,脾未触及。双下肢肌肉萎缩,肌力零度。实验室检查:血红蛋白<3g,红细胞83万,成熟红细胞未见畸形。白细胞9,600,中性分叶核占90％,可见毒性颗粒。血小板23万,网织红细胞绝对值1.3万。骨髓象:增生Ⅱ级,粒比红为7.6:1,粒细胞系统增生明显活跃,占有核细胞的68.5％,各阶段比例正常。红细胞
Patient Wang × ×, male, 37 years old, hospital number A67105. 1981 June due to trauma caused by double paraplegia, in September the same year due to fever (38 ℃) diagnosis of acute urinary tract infection, oral chloramphenicol, 2.0g per day, About 10 days, and add other antibiotics, 15 days after the temperature dropped to normal. 1 month later gradually palpitation shortness of breath, lower extremity edema. March 25, 1982 palpitations increased shortness of breath and accompanied by dizziness and tinnitus hospitalization. Physical examination: the appearance of severe anemia, thin face, no yellow skin and bleeding, superficial lymph nodes is not enlarged. Cardiorespiratory normal, fast heart, liver ribs 1cm, liver area have percussion pain, spleen not touched. Lower extremity muscle atrophy, muscle strength zero. Laboratory tests: hemoglobin <3g, 830,000 red blood cells, no abnormalities in mature red blood cells. White blood cells 9,600, neutral lobular accounted for 90%, showing toxic particles. 230,000 platelets, reticulocytes absolute value of 13,000. Bone marrow: hyperplasia grade Ⅱ, grain ratio of red to 7.6: 1, granulocyte proliferation significantly active system, accounting for 68.5% of the nuclear cells, the proportion of normal at all stages. Red blood cells