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患女,17岁。患急性气管炎静滴氨苄青霉素4g/d,连用2d后,全身出现斑丘疹,散在分布伴恶心、呕吐,尿量减少至250ml/24h,发展为尿闭。既往无肾脏病史。体检:体温36℃,血压18/13kPa,全身皮肤散布针尖大小、压之不退色、高出皮面之丘疹,有些为斑片状,以胸背及四肢伸侧为主。颜面浮肿。扁桃体不大。心肺腹(-)。双肾区叩击痛明显。双下肢轻度凹陷性水肿。尿蛋白(+++),红细胞(+++)/HP,白细胞(+)/HP,颗粒管型少许。尿素氮20mmol/L,二氧化碳结合力
Female, 17 years old. Acute bronchitis with intravenous infusion of ampicillin 4g / d, 2d even after use, the body appeared rash, scattered distribution with nausea, vomiting, decreased urine output to 250ml / 24h, developed into auria. No previous history of kidney disease. Physical examination: body temperature 36 ℃, blood pressure 18 / 13kPa, the size of the body spread the tip of the needle, the pressure does not fade, higher than the pimple papules, and some patchy to the chest and limb extensor oriented. Face swelling. Tonsils are not large. Cardiopulmonary abdominal (-). Kidney area percussion pain significantly. Lower limbs slightly depressed edema. Urinary protein (+++), erythrocytes (+++) / HP, leukocytes (+) / HP, a little granular tube. Urea nitrogen 20mmol / L, carbon dioxide binding power