临床生物化学病例分析

138(mol/L)3.212-30(%)1130-38(g/L)520-300(g/L)79110-150●●●●MCVRDWMCHC●22433●Bil(mol/L)10821ALP(U/L)31221~92AST(U/L)2866~13HAV—IgMUroBil2+●●AST●●ASTALP●1AST123456●2ALP●HAV—IgM●3385.7mmol/LNa143mmol/LK+2.9mmol/LTCO235mmol/L●●K+2.8mmol/L3.54.8mmol/LK+K+TCO2TCO2TCO235mmol/L2232mmol/LK+NaNaNaNa135145mmol/LNaK+NaK+NaNa140mmol/L136mmol/LK+454Crmol/L51260120Na(mmol/L)134135145K+mmol/L5.53.54.8TCO2(mmol/L)162232Cammol/L1.892.152.55Alb(g/L)313245Pimmol/L1.560.61.4UAmmol/L0.620.170.44●●●K+Na134mmol/L512mol/LNa134mmol/LGFRGFRK+55368CK440U/L81840CK(U/L)440347228220HBD(U/L)18018217950-220●●●CK40CKα-HBDCK1.CK6CKCK2.CKCK-MBCK6●CK627●TBil(mol/L)58021TP(g/L)5062-80Alb(g/L)3035-52ALP(U/L)20421-92AST(U/L)18206-35PT(s)15.911.5-15KPTT(s)46.725-37UroBil3+●●●●●ASTALP●●23101724TBil(mol/L)610526522413347ALP(U/L)204179205210208AST(U/L)182016881296670444●HbsAg●ASTALP●HbsAgHbeAgHbcHbeHbs,●248●775350g/L7312357Cr(mol/L)868745533438321Urea(mmol/L)44.238.328.023.715.6Na+(mmol/L)131135136140141K+(mmol/L)6.95.54.23.42.9TCO2(mmol/L)8109910●●●TCO2●GFRTCO2●83628kgT4(pmol/L)40.89.425.0TSH(mU/L)0.10.36.0●●●T4TSH●T4TSHTSHTSHGraves'●12T4(pmol/L)34.615.813.1TSH(mU/L)0.10.14.3●T41TSH2TSHT4T4●Graves'9945●Ureammol/L10.53.8-8.0Na+mmol/L136134-144K+mmol/L2.93.5-4.8TCO2mmol/L3524-32Glummol/L14.83.8-5.5TCmmol/L7.26.5TGmmol/L3.20.5-2.0HDL-Cmmol/L0.70.9●●●TCO21.NaNaHNaK2.93.4.●(2of2)2005-6-1718:17:231010723●Tbilumol/LALPumol/LASTumol/LALTU/LLDHU/LγGTU/L2418409798719252370901074301020●●AFP●ALPγ-GTASTALT●AFPAFPAFP10(2of2)2005-6-1718:18:47111127511.5/5.7kPa112/32/36.7mmol/L49%134mmol/L6.0mmol/LBUN16.2mmol/LpH6.8PaCO21.33kPa●●●5●pH6.8PaCO21.33kPaPaCO2●BUN●H+K+●(1of2)2005-6-1718:19:0611(2of2)2005-6-1718:19:0612125012165cm70kg18.3/12.0kPa74/72TG1.8mmol/LTC7.6mmol/LHDL-C1.1mmol/LLDL-C5.7mmol/L●●●●TCTGWHOa●LDL●TC4.0mmol/LLDL-C2.6mmol/L(1of2)2005-6-1718:19:3212(2of2)2005-6-1718:19:32131350U/L145.00046U/L198.00046mol/L55.70025mol/L17.4007g/L55.86080g/L27.13555U/L283.00555U/L412.0035134mmol/L3.103.55.5mmol/L150.00135145mmol/L93.0098106CO2mmol/L292129()●●(1of2)2005-6-1718:20:0013●●●CO2●(2of2)2005-6-1718:20:001414502120/32/17kPaNa+140mmol/LK+4.1mmol/LCl101mmol/LHCO325mmol/LBUN4.3mmol/LCr95mol/L●●●●BUNCr●242423mg7mg/24●●CT(1of2)2005-6-1718:20:2514●(2of2)2005-6-1718:20:25151572Crmol/L9075120BUNmmol/L4.33.07.0Na+mmol/L139135145K+mmol/L4.03.55.5Ca2mmol/L2.12.22.6Pimmol/L0.420.61.4Albg/L443555ALPU/L21435134X●●(1of2)2005-6-1718:20:4915●ALPALP●DDDALPPTH25(OH)D31,25(OH)2D3PTHD●D(2of2)2005-6-1718:20:491616543hCCUself-limitingepisode●14.6/12.0kPa78/S-TCrmol/L12260-120Ureammol/L9.22.5-8.0Na+mmol/L138135-145K+mmol/L3.23.5-4.8CKU/L90220HBDU/L17450-220●●●●(1of2)2005-6-1718:21:2916●ECG●ECGMICK4-6h4h●①②③CCU●ASTCK24hMIα-ECGMIMIECG2~3CKCKCKMB3BBCK-1MBCK-2MMCK-3CK-MMCK-MMCK-MBCK35%CK-MBCK5%CK-MBCK6%CK-MBCK6%(2of2)2005-6-1718:21:291818656kg●X●●●●65PSAALP0472037556366PSA(g/L)72.337.08.71.70.51.65.16.1ALP(U/L)470421357194206195205200●X●PSAPSAPSA10g/L(1of2)2005-6-1718:22:5618●●37PSAALP55PSA63“”PSA(2of2)2005-6-1718:22:561919723105●115/55mmHg75/●avFST0.15mvTCr(mg/dl)1.090.60-1.50BUN(mg/dl)123.00–20.00Na(mmol/L)137135-145CL(mmol/L)102.496-111CK(U/L)100200AST(U/L)255.00-37.00LD(U/L)18997.00-270.00●●●(1of2)2005-6-1718:23:2719●●CK4~6AST6~8LD12~243CKASTLD●0~4CTnICTnTCK-MB18.9%50%37.5%CTnICTnTCK-MBMb2MbMb●(2of2)2005-6-1718:23:27202038Na141mmol/L(132-144)K3.9mmol/L(3.2-4.8)Cl106mmol/L(98-108)HCO329mmol/L(23-33)Urea3.8mmol/L(3.0-8.0)Creat0.09mmol/L(0.06-0.12)CK3260U/L(20-250)LD404U/L(200)24CK230016331575U/LLD558322299U/LChol--7.1mmol/L(3.5-6.5)Trig--4.5mmol/L(0.3-1.7)tT410mmol/L(60-160)TSH250mU/L(0.2-5.6)(1of2)2005-6-1718:23:5320●●●①CK②LDCK●●CKASTLDCK(2of2)2005-6-1718:23:53CASE1CASE1HISTORYA28-year-oldmanisadmittedtohospitalwithaweek-longhistoryofseverevomiting