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Paget综合征：内分泌学会临床实践指南

2014-11-30 munan41 丁香园

Paget临床实践指南内分泌骨病膦酸
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Paget骨病，也称畸形性骨炎，是一种原因不明的慢性进行性骨代谢异常疾病，以局部骨代谢异常、骨重建障碍为特征。多见于老年人，随着年龄的增加发病率也会增加。 该病存在种族差异，英国、澳大利亚和欧洲多见，亚洲和非洲少见。目前Paget骨病尚无法治愈，治疗的目标是缓解疼痛、防止病变进展、矫正弯曲畸形、稳定病理性骨折等，以期提高患者生活质量。 2014年11月23日，Medpage Today刊登了一

Paget骨病，也称畸形性骨炎，是一种原因不明的慢性进行性骨代谢异常疾病，以局部骨代谢异常、骨重建障碍为特征。多见于老年人，随着年龄的增加发病率也会增加。

该病存在种族差异，英国、澳大利亚和欧洲多见，亚洲和非洲少见。目前Paget骨病尚无法治愈，治疗的目标是缓解疼痛、防止病变进展、矫正弯曲畸形、稳定病理性骨折等，以期提高患者生活质量。

2014年11月23日，Medpage Today刊登了一篇解析Paget骨病新临床实践指南的文章。

根据新的指南，内分泌学家应使用一次性静脉注射二膦酸盐，特别是唑来膦酸，来治疗Paget骨病。活动性Paget骨病患者存在患有并发症的风险，静脉注射应作为针对此类患者的一线治疗方法(肾功能减退者除外)。

美国加利福尼亚州圣莫尼卡John Wayne癌症研究所的Frederick Singer博士在指南中提出：唑来膦酸是Paget骨病患者的首选药物，理由是一次性注射唑来膦酸对该病的缓解作用长达6年之久，而口服药物的疗程最少要几个月，并且会引起胃肠道副作用，多数患者更希望采用前一种治疗方法。

该指南还建议将可疑骨病变的X线平片作为诊断Paget骨病流程的一部分。

在适当情况下，内分泌学家可通过测定血清总碱性磷酸酶(ALP)水平或特异性骨标记物来确定骨质破坏的程度，同时，骨标记物也可以帮助确定患者是否存在复发的情况。

该指南是由与欧洲内分泌协会合作的一个内分泌学会专责小组制定的，2014年11月9日发表在Journal of Clinical Endocrinology and Metabolism上。

原始出处

Kristina Fiore, Staff Writer.Guideline: Treat Paget's With Zoledronate.Medpage.2014

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1786058, encodeId=08d31e860581c, content=<a href='/topic/show?id=0202136e1e4' target=_blank style='color:#2F92EE;'>#Paget#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13671, encryptionId=0202136e1e4, topicName=Paget)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Mon Oct 19 07:46:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030979, encodeId=0add20309e93e, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sat Apr 18 17:46:00 CST 2015, time=2015-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21010, encodeId=80902101060, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:59:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682191, encodeId=21d316821917f, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Tue Oct 20 15:46:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323602, encodeId=edcf13236022d, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430488, encodeId=88d0143048861, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571928, encodeId=2fb315e1928e7, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=)]
    2015-10-19 minzju5052

    #Paget#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1786058, encodeId=08d31e860581c, content=<a href='/topic/show?id=0202136e1e4' target=_blank style='color:#2F92EE;'>#Paget#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13671, encryptionId=0202136e1e4, topicName=Paget)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Mon Oct 19 07:46:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030979, encodeId=0add20309e93e, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sat Apr 18 17:46:00 CST 2015, time=2015-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21010, encodeId=80902101060, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:59:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682191, encodeId=21d316821917f, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Tue Oct 20 15:46:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323602, encodeId=edcf13236022d, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430488, encodeId=88d0143048861, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571928, encodeId=2fb315e1928e7, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=)]
    2015-04-18 lvliquan

    #实践指南#

    0

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    2015-04-12 x35042875

    脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别

    0

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    2015-10-20 gwc392

    #分泌#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1786058, encodeId=08d31e860581c, content=<a href='/topic/show?id=0202136e1e4' target=_blank style='color:#2F92EE;'>#Paget#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13671, encryptionId=0202136e1e4, topicName=Paget)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Mon Oct 19 07:46:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030979, encodeId=0add20309e93e, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sat Apr 18 17:46:00 CST 2015, time=2015-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21010, encodeId=80902101060, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:59:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682191, encodeId=21d316821917f, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Tue Oct 20 15:46:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323602, encodeId=edcf13236022d, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430488, encodeId=88d0143048861, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571928, encodeId=2fb315e1928e7, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=)]
    2014-12-02 yanjie6253_56072842

    #临床实践#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1786058, encodeId=08d31e860581c, content=<a href='/topic/show?id=0202136e1e4' target=_blank style='color:#2F92EE;'>#Paget#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13671, encryptionId=0202136e1e4, topicName=Paget)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Mon Oct 19 07:46:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030979, encodeId=0add20309e93e, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sat Apr 18 17:46:00 CST 2015, time=2015-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21010, encodeId=80902101060, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:59:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682191, encodeId=21d316821917f, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Tue Oct 20 15:46:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323602, encodeId=edcf13236022d, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430488, encodeId=88d0143048861, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571928, encodeId=2fb315e1928e7, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=)]
    2014-12-02 zhouqu_8

    #综合征#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1786058, encodeId=08d31e860581c, content=<a href='/topic/show?id=0202136e1e4' target=_blank style='color:#2F92EE;'>#Paget#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13671, encryptionId=0202136e1e4, topicName=Paget)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Mon Oct 19 07:46:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030979, encodeId=0add20309e93e, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Sat Apr 18 17:46:00 CST 2015, time=2015-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21010, encodeId=80902101060, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:59:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682191, encodeId=21d316821917f, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Tue Oct 20 15:46:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323602, encodeId=edcf13236022d, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430488, encodeId=88d0143048861, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571928, encodeId=2fb315e1928e7, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=276d15780972, createdName=lily1621, createdTime=Tue Dec 02 03:46:00 CST 2014, time=2014-12-02, status=1, ipAttribution=)]
    2014-12-02 lily1621

    #临床实践指南#

    0