患者女,27岁,因头昏、乏力1周,黑便、皮肤紫癜4天,神志不清1天于1991年6月22日入院。患者因妊娠34周,1周前诉头昏、乏力来本院妇科检查,孕34周,BP19/13kPa。尿蛋白+.给予复降片、硫酸镁治疗后,头昏、乏力略好转。3日后,发现两下肢皮肤淤斑、紫癜并伴有黑便,血小板39×10~9/L,Hb66g/L、Ret0.085,T>5′,CT>4′30″。尿镜检红白细胞少许,颗粒管型(+)。拟诊伊文综合征、妊高征?而后全身紫癜、淤斑逐日增加,每日解黑便1次。入院前1天出现意识朦胧、燥动不安、渐入昏迷。诊断:血栓性血小板减少性紫癜(TTP)收住入院。既往身体健康。7年前曾在杭某医院作TTP抢救痊愈出院。体检:T38.2℃,神志不清,躁动。贫血貌,面部浮肿,巩膜皮肤中度黄染,全身皮肤见多处淤点、淤斑;浅表淋巴结未及,右侧鼻唇沟变浅、口角左歪,两肺 Female patient, 27 years old, because of dizziness, fatigue for 1 week, melena, skin purpura 4 days, confusion 1 day in June 22, 1991 admission. Patients due to 34 weeks of pregnancy, 1 week before the complaint vomiting, fatigue to our hospital gynecological examination, 34 weeks pregnant, BP19 / 13kPa. Urinary protein +. Given dipyridamole, magnesium sulfate treatment, dizziness, weakness slightly improved. 3 days later, found that the lower extremity skin ecchymosis, purpura accompanied by melena, platelet 39 × 10 ~ 9 / L, Hb66g / L, Ret0.085, T> 5 ’, CT> 4’30 " A small number of leukocytes, granular tube type (). To be diagnosed with Evans syndrome, pregnancy-induced hypertension? And then systemic purpura, ecchymosis day by day, daily solution to the black 1. On the day before admission, there was a sense of dim, restless, gradually Into the coma. Diagnosis: Thrombotic thrombocytopenic purpura (TTP) admitted to hospital. Previously healthy. 7 years ago in a hospital for TTP rescue healed discharged. Physical examination: T38.2 ℃, confusion, restlessness. Anemia Appearance, facial swelling, scleral skin moderate yellow dye, systemic skin see multiple deposition, ecchymosis; superficial lymph nodes, right shallow nasolabial fold, left crooked mouth, both lungs