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男,29岁,以间断尿黄,伴肝区不适三年,皮肤巩膜黄染一周,于1984年3月24日入院。三年来每于劳累及/或饮酒后有小便与皮肤发黄史,一周前因饮酒再次发病。平素健康,无明显乏力、纳差及肝炎病史,家族中无类似疾患。检查:皮肤、粘膜及巩膜均有黄染,无肝性面容、肝掌及蜘蛛痣,心肺(-),肝肋下未及,无触痛,脾未及,腹水征(-),双下肢无浮肿,尿胆红素阳性,尿胆原;肝功能:总胆红质3.2mg％,直接胆红素2.3％,HBsAg(-),抗HBs(-),AKP40u,酚絮试验(一),BSP排泄滞留(45分钟血清浓度为6mg％,120分钟升达7.5mg％)。胆囊造影:口服法未显影,静脉注射法示:形态功能正常,“B”型超声波示:肝内未见占位性病变,拟诊为黄疸原因待查。病理报告:肝穿刺标本呈黑褐色。镜下:
Male, 29 years old, with intermittent urinary yellow, with liver discomfort for three years, the skin scleral yellow dye a week, on March 24, 1984 admission. Over the past three years, every time tired and / or after drinking alcohol, there is a history of urination and skin yellowing. Usually healthy, no obvious fatigue, anorexia and hepatitis history, no similar disease in the family. Check: skin, mucous membranes and sclera are yellow dye, no liver face, liver palms and spider nevus, cardiopulmonary (-), liver ribs under, tenderness, spleen and ascites (-), both lower extremities HBsAg (-), anti-HBs (-), AKP40u, phenolic flocculation test (a) of the total bilirubin, , BSP excretion retention (45 minutes serum concentration of 6mg%, 120 minutes up 7.5mg%). Gallbladder angiography: oral method is not developed, intravenous injection method showed that: morphological function is normal, “B” -type ultrasound showed: no intrahepatic space-occupying lesions, the diagnosis of jaundice due to be diagnosed. Pathology report: Liver puncture specimen was dark brown. Mirror: