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1 病例报告例1:男,50天,因巩膜黄染伴尿深黄5天入院.患婴足月、顺产、第一胎,出生时体重2.2kg,未接受乙肝计划免疫.患母乙肝5项标记,HBsAg(+),余四项(一).否认家族性肝硬化史.查体:发育营养欠佳,慢性肝病面容.神清,囟门平,巩膜黄染(++),浅淋巴结未触及,无肝掌蜘蛛痣,心肺无异常,腹膨隆腹壁浅静脉显露,移动性浊音(一),肝肋下2cm,质偏硬,表面光滑,脾肋下2cm.CNS无异常.B超:右肝斜径73mm,门静脉7mm,胆总管2mm,血管走向不清,肝区光点分布不均,结构紊乱,脾厚21mm.实验室检查:甲、丙、丁和戌肝血清学标记皆(一),HBsAg和HBsAb均(++),乙肝标记余三项(一).聚合酶联法检测HBV-DNA(+).肝功能:TB96.9mmol/L,DB71.4mmol/L,AST84U,ALT61U,r-GT348U,A/G=16.蛋白电泳:A70.8%,α_1 2.3%,α_25.1%,β5.1%,γ16.7%.
1 case report Example 1: Male, 50 days, due to scleral yellow dye with urinary dark yellow 5 days admitted to hospital with full-term infants, birth, the first child, birth weight 2.2kg, did not receive hepatitis B immunization. Item mark, HBsAg (+), the remaining four (a). Deny the history of familial cirrhosis. Physical examination: poor developmental and chronic liver disease, facial clear. Fontanelle, scleral yellow dye No palpable nevus, palpus without liver palpitations, no abnormality in heart and lung, superficial veins of abdominal bulging abdomen, mobile dullness (1), 2 cm inferior hepatic ribs, moderate hardness, smooth surface, : Right hepatic oblique diameter 73mm, portal vein 7mm, common bile duct 2mm, vascularized unclear, uneven distribution of light spots in the liver, structural disorders, splenomegaly 21mm. Laboratory tests: A, C, D and Xu liver serology markers (A), HBsAg and HBsAb (++), hepatitis B markers more than three (a). Polymerase chain reaction detection of HBV DNA (liver function: TB96.9mmol / L, DB71.4mmol / L, AST84U , ALT61U, r-GT348U, A / G = 16. Protein electrophoresis: A70.8%, α_1 2.3%, α_25.1%, β5.1%, γ16.7%.