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患者男性,48岁,1986年3月14日起床时感左背痛,发热。血压126/80mmHg,无贫血和黄疸,肝助下两指,脾肋下1.5指。四肢无出血点和浮肿。神经系统无异常。血小板84.8×10~4/μl,白细胞18100/μl。Pb染色体阴性。血小板粘附功能正常,血小板聚集功能降低。骨髓有核细胞7.9×10~4/μl,巨核细胞10/μl。骨髓活检提示巨核细胞增加,血小板成簇可见。GOT,GPT轻度升高。C反应蛋白+++。腹部CT显示轻度肝肿大和中度脾肿大,约75%的区域边缘呈不规则低吸收区。造影CT:脾上极侧约75%的范围有脾梗塞。腹部血管造影:动脉相,在脾动脉上终动脉根部有闭塞;毛细血管相,在脾下极侧约25%的范围呈浓染;系脾动脉上终动脉栓塞引起脾上极侧约70-75%的范围内脾梗塞。诊断为脾动脉栓塞引起
Male patient, 48 years old, March 14, 1986 Get up feeling left back pain, fever. Blood pressure 126 / 80mmHg, no anemia and jaundice, liver assist two fingers, 1.5 spleen ribs. No bleeding limbs and edema. Nervous system no abnormalities. Platelets 84.8 × 10 ~ 4 / μl, white blood cells 18100 / μl. Pb chromosome negative. Platelet adhesion function is normal, reduced platelet aggregation. Bone marrow nucleated cells 7.9 × 10 ~ 4 / μl, megakaryocytes 10 / μl. Bone marrow biopsies suggest that megakaryocytes are increased and platelets are clustered. GOT, GPT increased slightly. C-reactive protein +++. Abdominal CT showed mild hepatomegaly and moderate splenomegaly, about 75% of the regional edge showed irregular low absorption area. Contrast CT: spleen infarction on the extreme side of about 75% of the spleen. Abdominal angiography: arterial phase, the terminal artery root of the splenic artery occlusion; capillary phase, the spleen in the extreme side of about 25% of the range of thick dye; Department of splenic artery on the terminal splenic artery caused by the extreme side of about 70- 75% of the range of splenic infarction. Diagnosis of splenic artery embolism caused