半乳糖血症:症状与体征、病因、流行病学、诊断与治疗

2022-09-17 MedSci原创 MedSci原创 发表于上海

半乳糖血症(galactosemia,GAL) 是一种由于半乳糖代谢通路中酶缺陷所引发的常染色体隐性遗传代谢病。根据酶缺陷的类型将半乳糖血症分为 3 型:半乳糖 -1- 磷酸尿苷转移酶缺乏型(gala

半乳糖血症(galactosemia,GAL) 是一种由于半乳糖代谢通路中酶缺陷所引发的常染色体隐性遗传代谢病。根据酶缺陷的类型将半乳糖血症分为 3 型:半乳糖 -1- 磷酸尿苷转移酶缺乏型(galactose-1-phosphate uridyltransferase[GALT]deficiency)、半乳糖激酶缺乏型(galactokinase[GALK]deficiency) 和尿苷二磷酸 - 半乳糖 -4- 表异构酶缺乏型(uridine diphosphate galactose-4-epimerase[GALE]deficiency)。其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。

一、一般概述

半乳糖血症是一种罕见的、遗传性的碳水化合物代谢紊乱,影响身体将半乳糖转化为葡萄糖的能力。半乳糖是牛奶中含有的一种糖,包括人类母亲的牛奶以及其他乳制品。它也可以由人体产生,这被称为内源性半乳糖。葡萄糖是一种不同类型的糖。这种疾病是由一种对该过程至关重要的半乳糖-1-磷酸尿苷转移酶(GALT)的缺乏引起的。早期诊断和限制乳糖(无乳制品)饮食的治疗是绝对必要的,以避免在新生儿期出现严重的智力障碍、肝衰竭和死亡。半乳糖血症是一种常染色体隐性遗传病。典型的半乳糖血症和临床变异型半乳糖血症都会导致危及生命的健康问题,除非在出生后不久从饮食中去除乳糖。一种被称为Duarte的生化变异形式的半乳糖血症被认为不会因为食用乳糖而导致临床疾病。

二、症状与体征

患有半乳糖血症的婴儿在出生时看起来很正常,但在几天或几周内就会失去食欲并开始过度呕吐。皮肤、粘膜和眼白发黄(黄疸),肝脏肿大(肝肿大),尿液中出现氨基酸和蛋白质,发育不良,最终腹腔积液(腹水),腹部肿胀(水肿)也可能发生。腹泻、烦躁、嗜睡和细菌感染也可能是半乳糖血症的早期症状。随着时间的推移,除非从饮食中去除乳糖,否则会出现身体组织的消耗、明显的虚弱和极度的体重下降。

患有半乳糖血症的儿童如果没有得到早期治疗,可能会出现身体和智力发育停滞,在婴儿期或儿童期特别容易患白内障。在受影响严重的儿童中,新生儿期的压倒性感染可导致危及生命的并发症,但患有杜阿尔特变异性半乳糖血症的儿童可能很少有征兆,也没有严重的损伤()。

为了避免半乳糖血症的后果,可能包括肝衰竭和肾功能障碍、脑损伤和/或白内障,婴儿必须及时治疗,从饮食中去除乳糖。用这种特殊饮食治疗的儿童仍可能出现并发症。言语和学习困难以及一些行为问题仍有可能发生。卵巢功能损害几乎总是出现在患有典型半乳糖血症的女孩身上,并与促性腺激素、卵泡刺激素(FSH)的血液水平增加有关;患有半乳糖血症的男性通常不会表现出性腺功能的异常。

上述与典型半乳糖血症和临床变异性半乳糖血症有关的并发症没有发生在杜阿尔特变异性半乳糖血症(一种生化变异性半乳糖血症)患者身上。然而,在这些儿童中,少数人出现了发育迟缓和/或语言异常,但目前还不清楚这是否与半乳糖及其代谢物的积累有关。患有杜阿尔特变异型半乳糖血症的人不需要保持特殊的饮食。

三、病因

半乳糖血症的发生是由于GALT基因的破坏或变化(突变)导致GALT酶的缺乏。这导致与半乳糖有关的化学物质在身体各器官中的异常积累,引起半乳糖血症的症状和体征。

GALT酶是分解牛奶糖--半乳糖所必需的。这种酶的缺乏导致有毒产品的积累:半乳糖-1-磷酸(半乳糖的衍生物)和半乳糖醇(半乳糖的酒精衍生物)。半乳糖醇积聚在眼睛的晶状体中,导致晶状体肿胀和蛋白质沉淀,随后导致白内障。半乳糖-1-磷酸的积累被认为是导致其他疾病症状和体征的原因。

半乳糖血症是一种常染色体隐性遗传疾病。当一个人从父母双方继承了一个不工作的基因时,就会发生隐性遗传病。如果一个人接受了一个工作基因和一个非工作基因的疾病,这个人将是疾病的携带者,但通常不会出现症状。两名携带者的父母同时传递非工作基因的风险是25%,因此,每次怀孕都有一个受影响的孩子。每次怀孕时,孩子与父母一样是携带者的风险是50%。孩子从父母双方获得工作基因的机会是25%。男性和女性的风险是一样的。

四、流行病学

通过世界各地的新生儿筛查项目,典型的半乳糖血症的诊断率在1/16,000到1/48,000之间,取决于该项目使用的诊断标准。这种疾病在所有种族群体中都有报道。半乳糖血症在爱尔兰血统的人中发生的频率增加。临床变异型半乳糖血症最常发生在非裔美国人和南非的本地非洲人身上,他们有一个特定的基因突变。

根据美国全国新生儿筛查结果,经典型半乳糖血症的发病率为 1/48 000。浙江省新生儿筛查数据显示,半乳糖血症总体患病率为1/189 857,其中 GALT 缺乏导致的经典型半乳糖血症的发病率为1/759 428。

五、鉴别诊断

以下疾病的症状与半乳糖血症的症状相似。比较可能对鉴别诊断有帮助。

半乳糖激酶(GALK)缺乏症与白内障、血液中半乳糖浓度增加和尿液中半乳糖醇浓度增加有关。半乳糖醇积聚在眼睛的晶状体中,导致晶状体肿胀和蛋白质沉淀,随后出现白内障。GALK缺乏症是一种常染色体隐性遗传疾病,由GALK1基因的突变引起,诊断为GALK酶活性降低。

尿素二磷酸半乳糖4-epimerase(GALE)缺乏症在新生儿期出现时与GALT缺乏症相似。严重的形式只在8名患者中报道过。GALE缺乏症是一种常染色体隐性遗传病,由GALE基因的突变引起,通过GALE酶的活性降低来诊断。

乳糖不耐受症(LI)是一种代谢性疾病,其特征是不能分解乳糖,乳糖是牛奶和奶制品中的主要糖类。患有乳糖不耐受症的人不能正常消化乳糖,因为他们缺乏或缺少肠道酶,即乳糖酶,而乳糖酶是消化乳糖的关键。乳糖是一种复杂的糖,由两个不同的糖分子(双糖)组成,即半乳糖和葡萄糖,每一种都是单糖(单糖),更容易被人体肠道吸收并在其他器官中加工。缺乏乳糖酶的人在吃或喝富含乳糖的食物后会出现痉挛、恶心、腹胀、胃部隆起(Borborygmi)、排气(flatus)和/或腹泻,而这些食物并非都是乳制品。如果体征发生在新生儿身上,则更为严重。先天性乳糖不耐受的体征在出生后不久就很明显,通常包括严重腹泻、呕吐、体液水平异常低下(脱水)和不能茁壮成长。

希特林蛋白缺乏症 希特林(Citrin) 蛋白缺乏所致的新生儿肝内胆汁淤积症(NICCD) 临床表现亦以黄疸、肝大、肝功能异常为主要表现,但一般伴有高氨血症、低血糖、低蛋白血症、甲胎蛋白升高、血浆氨基酸检测显示瓜氨酸、酪氨酸等增高,较少合并白内障,症状多为自限性,可通过 SLC25A13 基因检测鉴别。

胆汁淤积症  临床可表现为黄疸、皮肤瘙痒、肝肿大,伴大便颜色变浅,生化检测以胆汁酸升高为主,转氨酶和胆红素轻度升高,肝胆超声检查和胆道造影可鉴别。

尼曼匹克病 C 型 是因 NPC1(MIM 257220) 和 NPC2(MIM 601015) 基因突变导致的胆固醇转运障碍,临床以肝脾肿大、神经系统受累为主要表现,发病年龄各异,少数可在新生儿期起病,表现为黄疸消退延迟、胆汁淤积等,骨髓检查发现特征性的泡沫细胞,血 7- 酮胆固醇增高以及基因检测有助鉴别。

肝豆状核变性   典型表现为肝病、神经系统异常、角膜 K-F 环阳性。此病多在学龄前期以后起病,多在体检时发现肝功能异常而就诊,血中铜蓝蛋白水平明显降低,尿铜排出增多,少数可出现神经系统症状,以锥体外系症状为主,ATP7B 基因检测可明确诊断。

新生儿肝炎是一个通用术语,用于表示出生前和/或出生后不久发生的肝脏损伤。新生儿肝炎可能是由病毒、代谢性疾病或遗传性疾病,以及其他影响或损害肝脏功能的罕见疾病引起。在一些儿童中,肝脏损伤的原因不明--这些情况被称为特发性新生儿肝炎(INH)。特发性新生儿肝炎的症状可能因人而异,差别很大。肝病的常见表现经常出现,包括眼白和皮肤发黄(黄疸),肝脏肿大(肝肿大)和尿液异常深色。大多数患有特发性新生儿肝炎的人可以完全康复;然而,有些人会发展成慢性肝病。

由于本病缺乏临床特异性,故需注意与其他引起黄疸、肝肿大、肝功能异常的疾病相鉴别。如瓜氨酸血症Ⅰ型、酪氨酸血症Ⅰ型、丙酸血症等,均可通过代谢产物检测及相应基因检测进行鉴别

六、诊断

当红细胞中半乳糖-1-磷酸升高而GALT酶活性降低时,可诊断为典型半乳糖血症和临床变异型半乳糖血症。分子遗传学检测也可用于识别GALT基因的突变。

在新生儿筛查项目中,几乎100%的半乳糖血症婴儿可以通过脚后跟的血样进行诊断。如果不测量GALT酶的活性,临床变异型半乳糖血症的婴儿在新生儿筛查中可能被遗漏。

遗传咨询与产前诊断

本病为常染色体隐性遗传病。先证者父母通常为无症状的 GALT 致病变异携带者。先证者的同胞成为患者或成为正常个体的概率均为 25%,成为致病等位基因携带者的概率为50%。当先证者基因诊断明确时,可以通过羊水细胞或绒毛膜细胞对胎儿进行产前诊断。对未经产前检查出生的高危新生儿,应进行红细胞 GALT 酶检测和(或) 基因检测,以便早期筛查、诊断和治疗。

诊疗流程

七、治疗

患有半乳糖血症的婴儿和儿童应该采用限制乳糖的饮食(无乳制品),其中包括无乳糖的牛奶替代品和其他食物,如大豆制品。

不应对患有半乳糖血症的儿童进行乳糖耐量测试。幸运的是,患有半乳糖血症的婴儿可以在食物中没有半乳糖的情况下合成半乳糖脂和其他必要的含半乳糖的化合物。因此,如果严格遵守饮食规定,基本上可以实现令人满意的身体发育。

对于患有儿童语言障碍或构音障碍的儿童,可能需要进行语言治疗。对于学龄儿童来说,根据心理发展评估,一些人可能需要个人教育计划和/或学习技能的专业帮助。激素替代疗法也可用于青春期延迟和青春期后期继发性月经丧失的病例,称为卵巢早衰(POI)。

适当的治疗(即抗生素药物)可用于控制新生儿期的感染。严格的饮食对情绪的影响可能需要在整个儿童期给予关注和支持性措施。

建议对有半乳糖血症儿童的家庭进行遗传咨询。

经过几次会议,2017年发表了关于半乳糖血症患者的治疗和随访的共识

八、罕见病信息登记

如果您愿意寻求不断更新的信息,建议您在此登记患者的信息,即使没有完全确诊,也可以登记,点击进入:

罕见疾病患者信息登记系统

参考资料:

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
    2022-09-17 133e980am04暂无昵称

    说的很详细,受益了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
    2022-09-17 ms1000000676229209

    其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
    2022-09-16 xugumin
  8. [GetPortalCommentsPageByObjectIdResponse(id=1719186, encodeId=e7791e19186e8, content=<a href='/topic/show?id=e32e915e89c' target=_blank style='color:#2F92EE;'>#诊断与治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91578, encryptionId=e32e915e89c, topicName=诊断与治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=85a832689492, createdName=木头人524, createdTime=Thu Mar 16 01:42:27 CST 2023, time=2023-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249579, encodeId=85b112495e9a9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:32:08 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249578, encodeId=e39812495e826, content=说的很详细,受益了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43713647273, createdName=133e980am04暂无昵称, createdTime=Sat Sep 17 07:31:59 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249577, encodeId=f8c512495e7ac, content=<a href='/topic/show?id=8f275032126' target=_blank style='color:#2F92EE;'>#期刊论坛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50321, encryptionId=8f275032126, topicName=期刊论坛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:55 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249576, encodeId=fcb212495e63e, content=其中 GALT 缺乏引起的半乳糖血症相对常见,也被称为经典型半乳糖血症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=069d8286897, createdName=ms1000000676229209, createdTime=Sat Sep 17 07:10:44 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1249575, encodeId=de7812495e528, content=<a href='/topic/show?id=fd1f35e9824' target=_blank style='color:#2F92EE;'>#半乳糖血症#</a><a href='/topic/show?id=5a8be955621' target=_blank style='color:#2F92EE;'>#罕见病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35798, encryptionId=fd1f35e9824, topicName=半乳糖血症), TopicDto(id=79556, encryptionId=5a8be955621, topicName=罕见病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Sat Sep 17 07:05:27 CST 2022, time=2022-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411484, encodeId=a9cd14114847a, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588756, encodeId=aa141588e569a, content=<a href='/topic/show?id=8ac523668e8' target=_blank style='color:#2F92EE;'>#乳糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23668, encryptionId=8ac523668e8, topicName=乳糖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5a17619424, createdName=minzju5058, createdTime=Fri Sep 16 22:42:27 CST 2022, time=2022-09-16, status=1, ipAttribution=)]
    2022-09-16 minzju5058

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