Datos de examen médico establecidos para 1 millón de niveles

{
  "anon_id": "PHY-2021-Q3R7B1L9W2",
  "report_id": "RPT-S-FDZS-20230520-0147",
  "meta": {
    "quality_grade": "S+",
    "source_institution": "合作医疗机构体检中心",
    "institution_tier": "优质",
    "checkup_date": "2023-05-20",
    "is_longitudinal": true,
    "longitudinal_span_years": 3,
    "previous_report_ids": ["RPT-S-FDZS-20210518-0091", "RPT-S-FDZS-20220519-0122"]
  },
  "demographics": {
    "gender": "女", "birth_year": 1992, "age_at_checkup": 31,
    "height_cm": 163.0, "weight_kg": 54.2, "bmi": 20.4,
    "blood_pressure_mmhg": {"systolic": 108, "diastolic": 68}
  },
  "lab_results": {
    "thyroid_function": {
      "tsh_mIU_L": 2.35, "ft3_pmol_L": 4.8, "ft4_pmol_L": 15.2,
      "tpoab_IU_ml": 156.8
    },
    "biochemistry": {
      "fpg_mmol_L": 4.8, "hba1c_percent": 5.2,
      "tc_mmol_L": 4.65, "hdl_c_mmol_L": 1.72, "ldl_c_mmol_L": 2.45
    },
    "tumor_markers": {
      "afp_ng_ml": 2.5, "cea_ng_ml": 1.2, "ca125_U_ml": 18.6
    }
  },
  "imaging": {
    "thyroid_us": {
      "findings": "甲状腺实质回声不均匀，可见弥漫性低回声区，TI-RADS 2类。",
      "tirads": "2"
    },
    "breast_us": {
      "findings": "右乳10点方向低回声结节，8×5mm，边界清晰，BI-RADS 3类。",
      "birads": "3"
    }
  },
  "summary": {
    "main_findings": [
      "桥本氏甲状腺炎（TPOAb升高，甲状腺弥漫性病变）",
      "右乳结节 BI-RADS 3类（可能良性，建议短期随访）"
    ],
    "risk_stratification": "低危",
    "temporal_comparison": "TPOAb较2021年升高42 IU/mL（115→157），提示自身免疫活动进展"
  }
}

{
  "anon_id": "PHY-2022-D6K1J8P3Z5",
  "report_id": "RPT-S-SCRH-20230812-0201",
  "meta": {
    "quality_grade": "S",
    "source_institution": "合作医疗机构健康管理中心",
    "institution_tier": "优质",
    "checkup_date": "2023-08-12",
    "report_pages": 56, "effective_pages": 52,
    "imaging_count": 12, "original_price_cny": 12800
  },
  "demographics": {
    "gender": "男", "birth_year": 1958, "age_at_checkup": 65,
    "height_cm": 168.0, "weight_kg": 71.5, "bmi": 25.3,
    "blood_pressure_mmhg": {"systolic": 152, "diastolic": 92}
  },
  "lab_results": {
    "biochemistry": {
      "bun_mmol_L": 8.2, "cr_umol_L": 115, "egfr_ml_min": 58,
      "fpg_mmol_L": 7.8, "hba1c_percent": 7.2,
      "tc_mmol_L": 5.45, "ldl_c_mmol_L": 3.25
    },
    "tumor_markers": {
      "cea_ng_ml": 6.8, "psa_total_ng_ml": 6.5, "psa_ratio": 0.17,
      "ferritin_ng_ml": 385
    }
  },
  "imaging": {
    "chest_ct": {
      "findings": "右肺上叶后段实性结节，12×10mm，边缘毛糙，分叶征及短毛刺。纵隔4R区肿大淋巴结短径12mm。",
      "lung_rads": "4B", "nodule_count": 1, "largest_nodule_mm": 12
    },
    "coronary_cta": {
      "findings": "LAD近段混合性斑块，管腔狭窄约55%；Agatston钙化积分：285。",
      "agatston_score": 285, "lad_stenosis_percent": 55
    },
    "head_mri_mra": { "fazekas_grade": 1 }
  },
  "summary": {
    "main_findings": [
      "右肺上叶实性结节（Lung-RADS 4B，建议穿刺活检）",
      "冠脉粥样硬化（LAD中段狭窄55%，Agatston 285）",
      "2型糖尿病（HbA1c 7.2%）", "高血压病2级",
      "CKD 3a期（eGFR 58）", "CEA升高（6.8 ng/mL）",
      "PSA升高（6.5 ng/mL，f/t比值0.17）"
    ],
    "risk_stratification": "高危（心血管+肿瘤双重风险）",
    "temporal_comparison": "肺结节为新发；PSA由4.2升至6.5（+55%）；eGFR由65降至58"
  }
}

{
  "anon_id": "PHY-2023-M4W8T5K2H7",
  "report_id": "RPT-S-ZDYF-20230625-0155",
  "meta": {
    "quality_grade": "S",
    "source_institution": "合作医疗机构健康管理中心",
    "institution_tier": "高级",
    "checkup_date": "2023-06-25",
    "report_pages": 44, "effective_pages": 40,
    "imaging_count": 7, "original_price_cny": 8500
  },
  "demographics": {
    "gender": "女", "birth_year": 1978, "age_at_checkup": 45,
    "height_cm": 160.5, "weight_kg": 62.8, "bmi": 24.4
  },
  "lab_results": {
    "tumor_markers": {
      "afp_ng_ml": 3.8, "cea_ng_ml": 2.5, "ca125_U_ml": 68.5,
      "ca15_3_U_ml": 22.8, "he4_pmol_L": 72.5, "roma_index": 18.2
    }
  },
  "imaging": {
    "breast_mammography": {
      "findings": "右乳外上象限簇状多形性微钙化，范围约15×12mm，BI-RADS 4A类。",
      "birads": "4A", "microcalcifications": true
    },
    "gynecologic_us": {
      "findings": "左附件区囊性包块，42×35mm，壁薄光滑——左卵巢单纯性囊肿。",
      "endometrial_thickness_mm": 12
    }
  },
  "summary": {
    "main_findings": [
      "右乳BI-RADS 4A类（微钙化簇，建议穿刺活检）",
      "CA125升高（68.5 U/mL）", "左卵巢单纯性囊肿（42×35mm）"
    ],
    "risk_stratification": "中高危（乳腺4A类+CA125升高需排查）",
    "temporal_comparison": "微钙化簇为新发现；CA125由2022年32.5升至68.5（+111%）"
  }
}

{
  "anon_id": "PHY-2024-L2F6H9N4S1",
  "report_id": "RPT-S-SHGH-20240218-0208",
  "meta": {
    "quality_grade": "S+",
    "source_institution": "合作医疗机构体检中心",
    "institution_tier": "优质",
    "checkup_date": "2024-02-18",
    "report_pages": 48, "effective_pages": 45,
    "imaging_count": 9, "original_price_cny": 15800
  },
  "demographics": {
    "gender": "女", "birth_year": 1990, "age_at_checkup": 34,
    "height_cm": 158.0, "weight_kg": 50.5, "bmi": 20.2
  },
  "lab_results": {
    "genetic_testing": {
      "septin9_methylation": "阴性",
      "cancer_susceptibility_panel": {
        "brca1": "无致病/可能致病变异", "brca2": "无致病/可能致病变异",
        "mlh1/msh2/msh6/pms2": "无致病/可能致病变异"
      },
      "pharmacogenomics": {
        "cyp2c19": "*1/*1（快代谢型）",
        "cyp2d6": "*1/*10（中间代谢型）",
        "slco1b1": "*1a/*1b（正常转运体功能）",
        "mthfr_c677t": "CT（杂合突变，酶活性约65%）"
      }
    }
  },
  "imaging": {
    "whole_body_mri": { "findings": "全身DWI BS未见明显异常高信号灶。" },
    "breast_mri": { "findings": "未见异常强化灶，BI-RADS 1类。", "birads": "1" },
    "ai_fundus": { "dr_result": "阴性", "amd_result": "阴性", "glaucoma_risk": "低" }
  },
  "summary": {
    "main_findings": [
      "MTHFR C677T杂合突变（酶活性约65%）",
      "CYP2D6中间代谢型", "各项常规指标均在正常范围",
      "肿瘤易感基因未发现致病/可能致病变异"
    ],
    "risk_stratification": "低危",
    "pharmacogenomic_notes": "CYP2C19快代谢：氯吡格雷正常剂量；CYP2D6中间代谢：经此酶代谢药物需关注"
  }
}