必备:冠脉造影阅片要领

2015-07-08 心在线 心在线

  冠脉造影(CAG)是目前诊断冠心病的"金标准",可对冠脉病变进行定量测量,明确冠脉造影图像中左、右冠的主要血管,评估冠脉血流情况,评价心肌灌注,确定冠脉造影图像应采用的体位,有助于对特定的血管和节段选择最好的投照角度。   一、常用冠脉缩写   熟悉常用冠脉缩写对临床阅读报告很有帮助。   1.左前降支(LAD)

  冠脉造影(CAG)是目前诊断冠心病的"金标准",可对冠脉病变进行定量测量,明确冠脉造影图像中左、右冠的主要血管,评估冠脉血流情况,评价心肌灌注,确定冠脉造影图像应采用的体位,有助于对特定的血管和节段选择最好的投照角度。

  一、常用冠脉缩写

  熟悉常用冠脉缩写对临床阅读报告很有帮助。

  1.左前降支(LAD):对角支(D),间隔支(S),中间支(RM)。

  2.左回旋支(LCX):钝缘支(OM)

  3.右冠脉(RCA):左室后支(PLV)、后降支(PDA)、锐缘支(AM)。

  图1. 常用冠脉缩写及其解剖形态

  二、正常冠脉造影

  正常冠脉造影要求具备以下条件:在多个必要的投照角度上,清楚暴露全部冠脉主干、主要分支和分叉部位;冠脉分支无缺如;管径无狭窄,管壁光滑;TIM Ⅲ级血流。

  三、冠脉定量测量(QCA)

  需要对斑块近端正常段参考直径(图2中的1所示)、斑块最小直径(图2中的2所示)、斑块远端正常段参考直径(图2中的3所示)、病变总长度(图2中的4所示)、斑块负荷程度进行测量,为选择最合适的支架提供帮助。

  图2. 冠脉的定量测量

  四、冠脉造影的结果分析

  1.血管及病变部位的确定

  (1)偏心斑块:斑块主要附着于一侧管壁。

  (2)钙化斑块:沿血管斑块走行的高密度影。

  (3)弥漫病变:长度≧20 mm的病变。

  (4)分叉病变:粥样斑块位于血管分叉处。

  (5)开口病变:斑块位于距血管开口3~5 mm内。

  图3. 冠脉造影分叉病变(左)及开口病变(右)

  2.冠脉血流分级

  TIMI血流分级:0级:无灌注,闭塞部位及远端无造影剂充盈;1级:造影剂通过闭塞部位,但远端血管无灌注;2级:造影剂可达到远端血管,但充盈速度明显减慢;3级:远端血管充盈快速且完全。

  图4. TIMI血流分级(TFG)

  TIMI心肌灌注分级(TMPG)代表心肌微循环灌注的情况。有研究发现,TFG和TMPG与死亡率相关,随着TFG和TMPG的降低,患者的死亡率增高。

  3.血栓分级

  0级:无血栓;1级:管腔显影模糊;2级:有明确血栓,但<1/2血管直径;3级:血栓为1/2——2倍血管直径;4级:血栓≧2倍血管直径;5级:血栓完全堵塞血管。

  图5. 冠脉血栓4级(左)和5级(右)

  4.动脉瘤

  动脉瘤是指冠脉动脉局部发生扩张呈瘤样改变。评估分为3级:0级是指无瘤样扩张;1级是指瘤样扩张>1倍但<1.5倍正常段血管直径;2级是指瘤样扩张≧1.5倍正常段血管直径。

  图6. 动脉瘤2级

  5.冠脉病变形态学分类

  (1)AHA/ACC冠脉病变分型建议

  A型:长度<10 mm,向心性,非成角(<45度),无或很少钙化,无闭塞,非开口,非血栓。

  B型:呈管状,长度10~20 mm,离心性,中度成角(45~90度),中重度钙化,闭塞<3个月,开口病变,有分叉,有血栓。

  C型:长度>20 mm,呈弥漫性,近端扭曲,严重成角(>90度),闭塞>3个月或桥侧枝,无法保护主要分支,退行性静脉桥病变。

  (2)夹层分型

  A型:造影剂无滞留,冠脉腔内出现局限线性透光区。

  B型:冠脉腔内出现与血管平行的条状显影。

  C型:血管壁外造影剂滞留。

  D型:螺旋夹层。

  图7. 动脉夹层C型(左)和D型(右)

  (3)其他表现

  穿孔:术中造影剂外泄,属于灾难性事件;边支丢失:直径>1.5 mm且术前血流TIMI 2~3级的边支血管术后血流变为TIMI 0~1级;无复流:血管痉挛、斑块碎屑脱落导致远端血管栓塞、再灌注不良。

  6.狭窄程度的测定

  1级:无狭窄;2级:轻度狭窄<30%;3级:中度狭窄30%~50%;4级:重度狭窄50%~90%;5级:次全闭塞,>90%;6级:完全闭塞,无血流。

  五、清晰冠脉造影图像必备的条件

  1.造影导管稳定。若造影导管不稳定,可导致造影剂不能充盈,血管显像将受到较大影响。

  2.合适的角度。多角度、准确的角度投照,才能暴露清晰的术野。

  3.造影剂充盈良好。多取决于助手,要求准确把握造影剂推进的速度和时间。

  4.合适的照射强度,尤其是对肥胖的患者。

  5.通常造影留像时间为2——3个心动周期,应根据血流情况进行调整。

  六、冠脉造影的局限性

  1.不能显示<0.5 mm的血管病变。

  2.狭窄<50%或>75%的病变,冠脉造影判断良好,但介于50%——75%的病变,冠脉造影常低估病变程度。

  3.主要靠目测,主观性较大。

  4.投照可存在误差,血管未充分展开或重叠,不能正确认识病变。

  5.存在造影剂误差。

  6.血管痉挛时判断失误。血管痉挛在造影图像上表现为血管狭窄,易与动脉粥样斑块发生混淆。

  7.有些心梗患者冠脉造影正常或仅有轻度病变。

  以上内容根据西安交通大学第一附属医院方媛教授《冠脉造影解读》整理

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  1. [GetPortalCommentsPageByObjectIdResponse(id=33186, encodeId=fe90331860f, content=真不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:24:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33185, encodeId=63bb33185c5, content=收藏了,很有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:23:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32210, encodeId=4b7f32210c4, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01621631568, createdName=飞翔9899, createdTime=Fri Jul 10 09:43:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447177, encodeId=256c144e177d0, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493983, encodeId=495c14939831c, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31560, encodeId=9f8a315600e, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:09:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
    2015-07-21 qingfengqishi5

    真不错!

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=33186, encodeId=fe90331860f, content=真不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:24:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33185, encodeId=63bb33185c5, content=收藏了,很有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:23:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32210, encodeId=4b7f32210c4, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01621631568, createdName=飞翔9899, createdTime=Fri Jul 10 09:43:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447177, encodeId=256c144e177d0, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493983, encodeId=495c14939831c, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31560, encodeId=9f8a315600e, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:09:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
    2015-07-21 qingfengqishi5

    收藏了,很有用!

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    2015-07-10 飞翔9899

    受用

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=33186, encodeId=fe90331860f, content=真不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:24:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33185, encodeId=63bb33185c5, content=收藏了,很有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:23:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32210, encodeId=4b7f32210c4, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01621631568, createdName=飞翔9899, createdTime=Fri Jul 10 09:43:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447177, encodeId=256c144e177d0, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493983, encodeId=495c14939831c, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31560, encodeId=9f8a315600e, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:09:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=33186, encodeId=fe90331860f, content=真不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:24:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33185, encodeId=63bb33185c5, content=收藏了,很有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:23:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32210, encodeId=4b7f32210c4, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01621631568, createdName=飞翔9899, createdTime=Fri Jul 10 09:43:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447177, encodeId=256c144e177d0, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493983, encodeId=495c14939831c, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31560, encodeId=9f8a315600e, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:09:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
    2015-07-10 sodoo
  6. [GetPortalCommentsPageByObjectIdResponse(id=33186, encodeId=fe90331860f, content=真不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:24:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33185, encodeId=63bb33185c5, content=收藏了,很有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 21 00:23:00 CST 2015, time=2015-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32210, encodeId=4b7f32210c4, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01621631568, createdName=飞翔9899, createdTime=Fri Jul 10 09:43:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447177, encodeId=256c144e177d0, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493983, encodeId=495c14939831c, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Fri Jul 10 00:11:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31560, encodeId=9f8a315600e, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:09:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
    2015-07-08 huaxipanxing

    看看

    0

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