肾病综合征伴乳糜性腹水一例
JOURNAL OF CLINICAL INTERNAL MEDICINE(2011)
Abstract
老年患者,男性.因"腹胀半年,双下肢浮肿20余天"入院.无特殊病史.体格检查:血压145/90mmHg,腹肌稍紧张,膨隆,上腹部压痛,移动性浊音阳性,胫前凹陷性水肿.血清白蛋白21.5g/L,血清胆固醇16.3 mmol/L,甘油三酯2.7 mmol/L;尿蛋白(3+),24小时尿蛋白定量4653.6 mg;B超检查提示腹腔积液,行腹腔穿刺抽腹水共2次(分别抽出乳白色液体800ml、1800ml),乳糜试验阳性,腹水常规检查pH 6.80,比重1.01,白细胞计数100×106/L,李凡他试验阳性,细胞学、抗酸杆菌、腹水培养阴性,CT增强扫描提示双侧少量胸腔积液,腹水.
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