心电图基础知识总结,实用干货值得收藏!

2021-10-25 医学点滴 医学点滴

记住这些基础的心电图概念以及简明判断方法很重要!

心电图可以帮助诊断心律失常、心肌缺血、心肌梗死、心脏扩大、肥厚等病症,是临床医生必须掌握的一项专业技能。但心电图不好记、看不懂,怎么办?记住这些基础的心电图概念以及简明判断方法很重要!一起来看看吧

 

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常规导联位置

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心电图阅读(三步走)

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形成初步印象(宽、窄、快、慢)

 

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节律和心率(窦性P波)

形态、电压、时相

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心  律

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窦性心律:

异位心律:

 

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房性:房早(提前的1-2个P 波)【房早打乱窦房结的节奏,要重排,往往致使代偿间期不完全,P2-P 间距(早搏间期)+P -P4间距(代偿间期)≠2×任一窦PP间期】,房速(提前的3个以上的P 波),房扑、房颤(P波消失)

 

交界性:(逆行P 波)(前传:P -R<0.12s;逆传:R-P <0.20s;实为P 波与QRS波之间的叠加关系,无从属关系。实际上,交界性早搏并无P -R间期或R-P 间期而言)(若R-P 间期>0.20s,P 波就可能不是房室结电指令逆传上去心房所产生的)【可以代偿间期不完全,也可以代偿间期完全(若逆传不到心房或不能沿结间束逆传,则对窦房结构不成威胁)】

 

室性:提早出现宽大、畸形的QRS波(往往是代偿间期完全的)(窦性P波往往隐藏在QRS-T波群中,不下传的原因是室早逆传时造成房室结不应期)

 

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  • 主动性心律失常:“早搏”(主动性、抢先、快速型)

  • 被动性心律失常:“逸搏”(被动性、推迟、缓慢型)

  • 【窄QRS波:室上性;宽QRS波:室性】

 

心率(60-100bpm)(3大格、5大格)

 

  • 心律整齐时,心率=60/R-R间期(或P-P间期)

  • 心律不齐时,6秒内的心动周期数×10

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电轴(平均QRS心电轴)

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  • 右偏:右心室肥厚,右束支传导阻滞

  • 左偏:左心室肥厚,左束支传导阻滞,左前分支传导阻滞

 

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P  波

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【窦房结(位于右心耳与上腔静脉交界处)发放电指令,电激动从右上至左下在普通心房肌中传导,使整个心房肌除极,产生P波;除极后的心房肌要复原(“复极”),该过程中电的方向自左下往右上,产生Ta波】【心房肌除极后不久(约0.04s)心房开始收缩】

 

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  • P波直立(Ⅰ、Ⅱ、aVF、V4-6 )

  • P波倒置(aVR)

  • 形态:宽(左房增大),高尖(右房增大)

 

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  • 电压:<0.25mV(肢体),<0.20mV(胸前)

  • 时相:<0.12s(3小格)

 

 

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PR间期:P波起点到QRS波起点(正常值0.12-0.20s)(主要反映电指令在房室交界区内传导所需的时间)

 

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房室结生理特性和作用:

 

  • 生理性延迟作用

  • 滤过作用【通常只能让200次/分的电冲动通过(偶尔可更多)】【房扑、房颤(心房率250-600次/分)等快速型室上性心律失常中滤过作用表现突出】

 

1.PR缩短<0.12s:预激(旁路);P波在QRS前面的交界性心律失常

2.PR延长>0.20s:Ⅰ度房室传导阻滞;P波在QRS前面的交界性心律失常

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3.P波后R波脱落:Ⅱ度或者高度房室传导阻滞

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4.P波与QRS波无关系:Ⅲ度房室传导阻滞

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QRS波(心室除极)

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(除极后约0.04s心室便开始收缩)

 

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  • QRS波电压:RV5 高,左心室肥大;RV1 高,右心室肥大。

  • QRS波时限:束支传导阻滞

  • Q波:心肌梗死

  • 室性心律失常:室早,室速

 

左室肥厚

 

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右室肥厚

 

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右束支传导阻滞

 

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左束支传导阻滞

 

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预激综合征(δ波,P-R间期bian变短,QRS波增宽)(与左束支传导阻滞鉴别)

 

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急性广泛前壁心梗(与左束支传导阻滞鉴别)

 

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室早

 

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室早二联律

 

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短阵室速伴室早

 

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尖端扭转性室速伴QT延长(病因)

 

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心室扑动、心室颤动

 

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Q 波

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  • 正常情况下,Ⅱ、Ⅲ、aVF可见,V6可见,V5、V4少见

  • Q波时相<0.04s,深度<1/4×R((同一导联)

 

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ST段:心室缓慢复极

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【QRS波群终点(J点)至T波起点间的等电位线称为ST段,代表心室复极的平台期。

 

正常情况下,ST段与等电位线的主要部分在同一水平上。ST段潜在异常表现为相对于基线压低或抬高(多以J点后80ms处为测量点)。ST段长度的异常反映QT间期时限的变化。】

 

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ST段移位:

 

  • 压低:<0.05mV(ST段比基线压低>1.0mm称为ST段显著压低)

  • 抬高:V1-2<0.3mV;V3<0.5mV;其他导联<0.1mV(与基线相比,ST段抬高>1mm为ST段显著抬高)

 

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心肌梗死图形演变及分期

 

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  • 有ST段抬高:超急性(无Q波形成),急性(有Q波形成)

  • 无ST段抬高:陈旧性

 

心梗定位:

动态变化、定位(ST段抬高、Q波出现的导联)

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下壁心梗

 

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陈旧性前间壁心梗,完右

 

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陈旧性下壁、右室心肌梗死

 

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T  波

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【除极后心室肌要复原(复极),该过程比较特殊,特殊之处在于先除极者后复极,即心内膜最早开始除极,而复极却从心外膜面开始,除极和复极产生的向量方向相同,所以T波与QRS主波方向相同。】

 

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复极从心外膜面开始原因:

 

  • 心外膜有脂肪组织包围,温度较高,可加快此处的心肌复极;

  • 心肌收缩时心内膜面承受的压力大,将减慢复极的进程,结果使得心室复极便自心外膜面开始,向心内膜面扩布。

 

高钾

 

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U波(低钾)(与T波方向一致,振幅相当于T波振幅的5-25%)

 

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早搏的鉴别

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  • 提前出现的P 波:P R>0.12s(房早);P R <0.12s(交界性早搏)

  • 提前出现的QRS波:QRS宽(室性早搏);QRS窄(交界性早搏)

 

房早伴差传VS室早

 

  • 房早伴差传:代偿间歇不完全,QRS前有P

  • 室早:代偿间歇完全,QRS前无相关P

 

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心动过速(连续3次以上的早搏形成)

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窄QRS波心动过速:

 

  • 窦性心动过速(有窦性P波)(渐快渐慢)(心率:70、80、90、100、110、120)(120、110、100、90、80);窦房结折返型心动过速:突发突止。

 

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  • 房性心动过速(有房性P波)(房性自律性增高型心动过速、房内折返型心动过速)

  • 阵发性室上性心动过速(逆行P波)(分为房室结内折返型心动过速、房室折返型心动过速)

 

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  • 房扑(P波消失,代之F波:形态、振幅、间距都很匀齐,似锯齿样,一般在Ⅱ、Ⅲ、aVF导联上最好看)(250-350次/分)(V2、V3、aVF、V1鉴别阵发性室上速)

 

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  • 房颤(P波消失,代之f波:形态、间距及振幅均绝对不规则的颤动波,在V1导联上最好看)(350-600次/分)

 

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宽QRS波心动过速:

 

  • 房速(有P  波)

 

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  • 房颤伴室内传导阻滞(不齐)

  • 房颤伴预激(有delta波)

  • 室速(最具特征的标志:房室分离、心室夺获波、室性融合波)

 

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    2021-11-15 测血压

    明天学习

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    2021-10-28 ms5000000207350549

    易懂易记,好!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1070509, encodeId=ba4810e05092d, content=明天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ykGRcou2PxnPQC5twzEHcKBEDM3ib9lUhTSrkFjLcOKfmcyPIfMddkzeIVnkIaZlVCutkibqf9AUTYHzhOiavelQg/132, createdBy=d2f05306482, createdName=测血压, createdTime=Mon Nov 15 20:09:49 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064696, encodeId=112e10646962f, content=易懂易记,好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e5648081, createdName=ms5000000207350549, createdTime=Thu Oct 28 15:32:12 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064230, encodeId=e81d10642305a, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1b55442837, createdName=ms3000001962617292, createdTime=Wed Oct 27 00:35:29 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063983, encodeId=002910639831b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210901/969603a2377544169c0528539edd5ab7/50bbe992202d43569f6cc40d89829e36.jpg, createdBy=b54c5537441, createdName=智慧药, createdTime=Tue Oct 26 09:19:28 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063980, encodeId=3ac71063980e3, content=收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/23/e1d3f7f91889b87fdd359852996815cc.jpg, createdBy=65985084111, createdName=145bc59am16暂无昵称, createdTime=Tue Oct 26 09:04:07 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063954, encodeId=7829106395469, content=心电图不好记、看不懂,怎么办?记住这, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Oct 26 07:08:27 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063946, encodeId=165b1063946d9, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Tue Oct 26 03:37:10 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063931, encodeId=126f10639315c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Oct 25 23:30:27 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063912, encodeId=204e1063912ec, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644b2182796, createdName=1207866fm50(暂无昵称), createdTime=Mon Oct 25 23:13:48 CST 2021, time=2021-10-25, status=1, ipAttribution=)]
    2021-10-27 ms3000001962617292

    感谢

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1070509, encodeId=ba4810e05092d, content=明天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ykGRcou2PxnPQC5twzEHcKBEDM3ib9lUhTSrkFjLcOKfmcyPIfMddkzeIVnkIaZlVCutkibqf9AUTYHzhOiavelQg/132, createdBy=d2f05306482, createdName=测血压, createdTime=Mon Nov 15 20:09:49 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064696, encodeId=112e10646962f, content=易懂易记,好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e5648081, createdName=ms5000000207350549, createdTime=Thu Oct 28 15:32:12 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064230, encodeId=e81d10642305a, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1b55442837, createdName=ms3000001962617292, createdTime=Wed Oct 27 00:35:29 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063983, encodeId=002910639831b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210901/969603a2377544169c0528539edd5ab7/50bbe992202d43569f6cc40d89829e36.jpg, createdBy=b54c5537441, createdName=智慧药, createdTime=Tue Oct 26 09:19:28 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063980, encodeId=3ac71063980e3, content=收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/23/e1d3f7f91889b87fdd359852996815cc.jpg, createdBy=65985084111, createdName=145bc59am16暂无昵称, createdTime=Tue Oct 26 09:04:07 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063954, encodeId=7829106395469, content=心电图不好记、看不懂,怎么办?记住这, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Oct 26 07:08:27 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063946, encodeId=165b1063946d9, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Tue Oct 26 03:37:10 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063931, encodeId=126f10639315c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Oct 25 23:30:27 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063912, encodeId=204e1063912ec, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644b2182796, createdName=1207866fm50(暂无昵称), createdTime=Mon Oct 25 23:13:48 CST 2021, time=2021-10-25, status=1, ipAttribution=)]
    2021-10-26 智慧药

    学习学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1070509, encodeId=ba4810e05092d, content=明天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ykGRcou2PxnPQC5twzEHcKBEDM3ib9lUhTSrkFjLcOKfmcyPIfMddkzeIVnkIaZlVCutkibqf9AUTYHzhOiavelQg/132, createdBy=d2f05306482, createdName=测血压, createdTime=Mon Nov 15 20:09:49 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064696, encodeId=112e10646962f, content=易懂易记,好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e5648081, createdName=ms5000000207350549, createdTime=Thu Oct 28 15:32:12 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064230, encodeId=e81d10642305a, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1b55442837, createdName=ms3000001962617292, createdTime=Wed Oct 27 00:35:29 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063983, encodeId=002910639831b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210901/969603a2377544169c0528539edd5ab7/50bbe992202d43569f6cc40d89829e36.jpg, createdBy=b54c5537441, createdName=智慧药, createdTime=Tue Oct 26 09:19:28 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063980, encodeId=3ac71063980e3, content=收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/23/e1d3f7f91889b87fdd359852996815cc.jpg, createdBy=65985084111, createdName=145bc59am16暂无昵称, createdTime=Tue Oct 26 09:04:07 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063954, encodeId=7829106395469, content=心电图不好记、看不懂,怎么办?记住这, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Oct 26 07:08:27 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063946, encodeId=165b1063946d9, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Tue Oct 26 03:37:10 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063931, encodeId=126f10639315c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Oct 25 23:30:27 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063912, encodeId=204e1063912ec, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644b2182796, createdName=1207866fm50(暂无昵称), createdTime=Mon Oct 25 23:13:48 CST 2021, time=2021-10-25, status=1, ipAttribution=)]
    2021-10-26 145bc59am16暂无昵称

    收藏!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1070509, encodeId=ba4810e05092d, content=明天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ykGRcou2PxnPQC5twzEHcKBEDM3ib9lUhTSrkFjLcOKfmcyPIfMddkzeIVnkIaZlVCutkibqf9AUTYHzhOiavelQg/132, createdBy=d2f05306482, createdName=测血压, createdTime=Mon Nov 15 20:09:49 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064696, encodeId=112e10646962f, content=易懂易记,好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e5648081, createdName=ms5000000207350549, createdTime=Thu Oct 28 15:32:12 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064230, encodeId=e81d10642305a, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1b55442837, createdName=ms3000001962617292, createdTime=Wed Oct 27 00:35:29 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063983, encodeId=002910639831b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210901/969603a2377544169c0528539edd5ab7/50bbe992202d43569f6cc40d89829e36.jpg, createdBy=b54c5537441, createdName=智慧药, createdTime=Tue Oct 26 09:19:28 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063980, encodeId=3ac71063980e3, content=收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/23/e1d3f7f91889b87fdd359852996815cc.jpg, createdBy=65985084111, createdName=145bc59am16暂无昵称, createdTime=Tue Oct 26 09:04:07 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063954, encodeId=7829106395469, content=心电图不好记、看不懂,怎么办?记住这, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Oct 26 07:08:27 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063946, encodeId=165b1063946d9, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Tue Oct 26 03:37:10 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063931, encodeId=126f10639315c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Oct 25 23:30:27 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063912, encodeId=204e1063912ec, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644b2182796, createdName=1207866fm50(暂无昵称), createdTime=Mon Oct 25 23:13:48 CST 2021, time=2021-10-25, status=1, ipAttribution=)]
    2021-10-26 查查佳佳

    心电图不好记、看不懂,怎么办?记住这

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1070509, encodeId=ba4810e05092d, content=明天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ykGRcou2PxnPQC5twzEHcKBEDM3ib9lUhTSrkFjLcOKfmcyPIfMddkzeIVnkIaZlVCutkibqf9AUTYHzhOiavelQg/132, createdBy=d2f05306482, createdName=测血压, createdTime=Mon Nov 15 20:09:49 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064696, encodeId=112e10646962f, content=易懂易记,好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e5648081, createdName=ms5000000207350549, createdTime=Thu Oct 28 15:32:12 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064230, encodeId=e81d10642305a, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1b55442837, createdName=ms3000001962617292, createdTime=Wed Oct 27 00:35:29 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063983, encodeId=002910639831b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210901/969603a2377544169c0528539edd5ab7/50bbe992202d43569f6cc40d89829e36.jpg, createdBy=b54c5537441, createdName=智慧药, createdTime=Tue Oct 26 09:19:28 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063980, encodeId=3ac71063980e3, content=收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/23/e1d3f7f91889b87fdd359852996815cc.jpg, createdBy=65985084111, createdName=145bc59am16暂无昵称, createdTime=Tue Oct 26 09:04:07 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063954, encodeId=7829106395469, content=心电图不好记、看不懂,怎么办?记住这, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Oct 26 07:08:27 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063946, encodeId=165b1063946d9, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Tue Oct 26 03:37:10 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063931, encodeId=126f10639315c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Oct 25 23:30:27 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063912, encodeId=204e1063912ec, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644b2182796, createdName=1207866fm50(暂无昵称), createdTime=Mon Oct 25 23:13:48 CST 2021, time=2021-10-25, status=1, ipAttribution=)]
    2021-10-26 青荷之约

    👍👍👍

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1070509, encodeId=ba4810e05092d, content=明天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ykGRcou2PxnPQC5twzEHcKBEDM3ib9lUhTSrkFjLcOKfmcyPIfMddkzeIVnkIaZlVCutkibqf9AUTYHzhOiavelQg/132, createdBy=d2f05306482, createdName=测血压, createdTime=Mon Nov 15 20:09:49 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064696, encodeId=112e10646962f, content=易懂易记,好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e5648081, createdName=ms5000000207350549, createdTime=Thu Oct 28 15:32:12 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064230, encodeId=e81d10642305a, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1b55442837, createdName=ms3000001962617292, createdTime=Wed Oct 27 00:35:29 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063983, encodeId=002910639831b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210901/969603a2377544169c0528539edd5ab7/50bbe992202d43569f6cc40d89829e36.jpg, createdBy=b54c5537441, createdName=智慧药, createdTime=Tue Oct 26 09:19:28 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063980, encodeId=3ac71063980e3, content=收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/23/e1d3f7f91889b87fdd359852996815cc.jpg, createdBy=65985084111, createdName=145bc59am16暂无昵称, createdTime=Tue Oct 26 09:04:07 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063954, encodeId=7829106395469, content=心电图不好记、看不懂,怎么办?记住这, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Oct 26 07:08:27 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063946, encodeId=165b1063946d9, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Tue Oct 26 03:37:10 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063931, encodeId=126f10639315c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Oct 25 23:30:27 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063912, encodeId=204e1063912ec, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644b2182796, createdName=1207866fm50(暂无昵称), createdTime=Mon Oct 25 23:13:48 CST 2021, time=2021-10-25, status=1, ipAttribution=)]
    2021-10-25 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1070509, encodeId=ba4810e05092d, content=明天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ykGRcou2PxnPQC5twzEHcKBEDM3ib9lUhTSrkFjLcOKfmcyPIfMddkzeIVnkIaZlVCutkibqf9AUTYHzhOiavelQg/132, createdBy=d2f05306482, createdName=测血压, createdTime=Mon Nov 15 20:09:49 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064696, encodeId=112e10646962f, content=易懂易记,好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e5648081, createdName=ms5000000207350549, createdTime=Thu Oct 28 15:32:12 CST 2021, time=2021-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064230, encodeId=e81d10642305a, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1b55442837, createdName=ms3000001962617292, createdTime=Wed Oct 27 00:35:29 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063983, encodeId=002910639831b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210901/969603a2377544169c0528539edd5ab7/50bbe992202d43569f6cc40d89829e36.jpg, createdBy=b54c5537441, createdName=智慧药, createdTime=Tue Oct 26 09:19:28 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063980, encodeId=3ac71063980e3, content=收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/23/e1d3f7f91889b87fdd359852996815cc.jpg, createdBy=65985084111, createdName=145bc59am16暂无昵称, createdTime=Tue Oct 26 09:04:07 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063954, encodeId=7829106395469, content=心电图不好记、看不懂,怎么办?记住这, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Oct 26 07:08:27 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063946, encodeId=165b1063946d9, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Tue Oct 26 03:37:10 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063931, encodeId=126f10639315c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Oct 25 23:30:27 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063912, encodeId=204e1063912ec, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644b2182796, createdName=1207866fm50(暂无昵称), createdTime=Mon Oct 25 23:13:48 CST 2021, time=2021-10-25, status=1, ipAttribution=)]
    2021-10-25 1207866fm50(暂无昵称)

    谢谢分享

    0

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