血卟啉病的临床多样性.pdfVIP

中华现代临床 医学杂志 Ch inese Journ al of Current Clin ical Medicine 2008 年第 6 卷 第 4 期 ·313 · ·论 著 · 血卟啉病的临床多样性 1 2 1 林喜湘 , 李浪波 , 钟惠菊 [ 摘要] 目的 阐述血卟啉病临床表现的多样性、隐匿性, 给临床医生提供 更多的思维方法, 减 少误诊 误治。方法 温 习本院近 8 年来收治的 4 例血卟啉病患者的临床表现、体征、实验室检查结果; 总结近 10 年来 国内文献报道 的 172 例, 分析血 卟啉病 的临床特点、诱因及误诊情况。结果 血卟啉病患者以中青年为主, 有腹痛、精神神经 异常、皮肤损害三 大症状 。尚有 许多非主征的临床表现: 如消瘦、便秘、恶心、呕吐、行走困难、呛咳、瘫痪甚至 失明。感染、精神刺激、肝毒 性药物 可诱发本病 和 / 或导致病情加重 。结论 血卟啉病临床表现多样、常起病隐匿、易误诊, 越来越多地 受到临床医生 关注 。全面认识本病、 认真询 问病史, 结合实验室检查结果、慎行鉴别诊断, 可减少误诊误治。 [ 关键词] 血卟啉病; 多样性; 误诊 [ 中图分类号] R 589 . 8 [ 文献标识码] A [ 文章编号] 1726 - 75 87 ( 2008) 04 - 0313 - 04 Clin ical diver sity in h em atop orp hyr ia LIN Xixiang , LI Langbo, ZHONG Huij u. Xian gya Hospital , Zh on gna n University, Cha ngsh a 4 10078, Chin a [ Ab str act ] Obj ect ive In order to give clin ical doctors a wider thou ght an d decrease misdiagnosis an d mistreat ment, we analyzed th e various in sidiou s clinical manifestation of hematoporphyria . M eth od s Clinical man ifesta tions, physical sign , laboratory test result of 4 cases in recent 8 years diagnosed in our hosp ital were an alyzed . The clinical manifestation and motivation of hematoporphyria of 172 int ernal cases reported in recent 5 years was an a lyzed . R esu lt s Most of the cases were youth . Stomach ach e, sk in lesion and abnormality of n erves and mind were th e 3 main symptoms of h ematoporphyria, b esides, there were several other manifestation s su ch as athrepsy, con stip a tion , nausea, vomitin g, difficulty walking, buckin g, paralysis, blin dness. In fection and agitation could aggravate and in duce it. Various kind s of motivation could indu c