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《NT-proBNP临床应用中国专家共识》出台

2011-06-23 MedSci原创 MedSci原创

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        在今年年初举行的第三届全国心力衰竭大会上，中华医学会心血管病学分会、中国老年学学会心脑血管病专业委员会、中国医师协会心血管内科医师分会与长城国际心脏病学会议组委会出台了《NT-proBNP临床应用中国专家共识》（简称《共识》），旨在进一步规范我国NT-proBNP的临床应用，提高我国心衰的诊治水平，介绍我国的研究

        在今年年初举行的第三届全国心力衰竭大会上，中华医学会心血管病学分会、中国老年学学会心脑血管病专业委员会、中国医师协会心血管内科医师分会与长城国际心脏病学会议组委会出台了《NT-proBNP临床应用中国专家共识》（简称《共识》），旨在进一步规范我国NT-proBNP的临床应用，提高我国心衰的诊治水平，介绍我国的研究成果与临床经验。

       日前，《共识》发起者、中华医学会心血管病分会主任委员胡大一教授，中华医学会心血管病分会常委、心力衰竭专业组组长黄峻教授分别就《共识》的背景、意义及临床应用进行详细解读。

       NT-proBNP：心衰重要生物标志物

       无论新发生的急性心衰，还是慢性心衰急性加重，血液的NT-proBNP水平均呈显著上升，且程度与心衰严重程度平行，病情缓解或有效治疗后回降。相比症状和体征，NT-proBNP能为诊断和鉴别诊断、危险分层、预后评估、指导个体化治疗和疾病管理提供客观指导。我国的2007年《慢性心力衰竭诊断治疗指南》和2010年《急性心力衰竭诊断治疗指南》均建议NT-proBNP用于心力衰竭的诊断和预后判断。
 
       “早在2005年，在全球范围就已基本肯定了NT-proBNP对于心衰诊断、评估和预后的临床价值，它是从一百多种不同指标中筛选出来的，至少迄今为止，没有比它更好的指标。”黄峻教授补充道。

       NT-proBNP在急性呼吸困难鉴别诊断、预后判断和指导治疗中的应用

       NT-proBNP是诊断筛查急性心衰的最佳敏感标志物。《共识》指出：对急性呼吸困难患者，结合病史、症状、体征、胸片、超声心动图和实验室检查，就诊时检测NT-proBNP对鉴别呼吸困难的原因是否为急性心衰有很大帮助。

        《共识》推荐采用“双截点”策略（见表）。黄峻教授提醒临床医生，程度较轻的急性心衰或非急性心衰（如心肌缺血、房颤、肺部感染、肺癌、肺动脉高压或肺栓塞等）者的检测值可介于两截点间（“灰区”），应结合其他检查鉴别诊断。

       急性心衰患者就诊时和治疗后的NT-proBNP水平具有重要的预后（预测近期或远期心血管病死亡或心力衰竭加重住院）价值，NT-proBNP越高，患者预后越差。因此，建议在患者就诊时（治疗前）和治疗后病情稳定时作NT-proBNP的系列检测，如治疗后NT-proBNP下降 30%以上，考虑患者预后良好；如无治疗前NT-proBNP检测数据，＜4000 ng/ml也可作为治疗后预后改善的指标。动态监测NT-proBNP水平并结合临床评估指导心衰治疗，有可能进一步降低死亡及心衰再住院风险。
       
        NT-proBNP在慢性心衰诊断、预后判断和治疗指导中的作用

       总体而言，慢性心衰患者的NT-proBNP 水平高于正常人和非心力衰竭者，但程度不及急性心衰。因我国尚无较大病例数的比较研究，《共识》建议采用2008年《欧洲急性与慢性心力衰竭诊疗指南》推荐标准：NT-proBNP＜400 pg/ml者慢性心力衰竭可能性甚小，＞2000 pg/ml者十分可能，400～2000 pg/ml者不确定，需进一步鉴别诊断。需强调，应当结合患者的临床表现、心电图、胸片和超声心动图检查进行多指标的鉴别诊断。

       NT-proBNP水平是慢性力衰的独立预后因素之一，并适用于不同严重程度的心衰患者。在慢性心衰患者，重复检测NT-proBNP更有助于判断远期预后，因此建议用于每位患者。NT-proBNP在指导心衰治疗中的地位也得到了来自麻省医院心脏病中心的印证，其完成的NT-proBNP门诊充血性心衰患者特定治疗（PROTECT）研究比较了NT-proBNP浓度检测指导心衰治疗和无NT-proBNP检测指导的标准心衰治疗，发现NT- proBNP指导的心衰治疗可显著减少慢性收缩性心衰患者的心血管事件。

       此外，黄峻教授还指出，NT-proBNP也是冠心病的独立预后因素，有助预测心衰或死亡危险，就诊时检测NT-proBNP可成为ACS患者的预后判断和治疗决策依据。

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    2015-09-27 irfan

    Thanky Thanky for all this good inroomatifn!

    0

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    2012-04-21 clmlylxy

    #临床应用#

    0

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    2011-09-17 snowpeakxu

    #专家共识#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=37407, encodeId=e3f23e40729, content=Thanky Thanky for all this good inroomatifn!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=irfan, createdTime=Sun Sep 27 07:49:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835546, encodeId=63201835546b3, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Sat Apr 21 22:08:00 CST 2012, time=2012-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844373, encodeId=b1a018443e368, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sat Sep 17 21:08:00 CST 2011, time=2011-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741322, encodeId=981b1e413220d, content=<a href='/topic/show?id=c2c621665c4' target=_blank style='color:#2F92EE;'>#中国专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21665, encryptionId=c2c621665c4, topicName=中国专家共识)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=218a34934063, createdName=12498f1em19(暂无昵称), createdTime=Fri Mar 16 21:08:00 CST 2012, time=2012-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2691, encodeId=f25a2691f9, content=很有帮助，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c3c43454, createdName=evacai, createdTime=Tue Aug 09 19:39:00 CST 2011, time=2011-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2657, encodeId=1418265edc, content=有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=768c43348, createdName=ifaifa, createdTime=Sun Aug 07 11:41:00 CST 2011, time=2011-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289276, encodeId=515c12892e6a2, content=<a href='/topic/show?id=ede136018b' target=_blank style='color:#2F92EE;'>#BNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3601, encryptionId=ede136018b, topicName=BNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290322, encodeId=624f12903226b, content=<a href='/topic/show?id=f6e513111bc' target=_blank style='color:#2F92EE;'>#NT-proBNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13111, encryptionId=f6e513111bc, topicName=NT-proBNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601652, encodeId=0cca16016528b, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=)]
    2012-03-16 12498f1em19(暂无昵称)

    #中国专家共识#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=37407, encodeId=e3f23e40729, content=Thanky Thanky for all this good inroomatifn!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=irfan, createdTime=Sun Sep 27 07:49:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835546, encodeId=63201835546b3, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Sat Apr 21 22:08:00 CST 2012, time=2012-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844373, encodeId=b1a018443e368, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sat Sep 17 21:08:00 CST 2011, time=2011-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741322, encodeId=981b1e413220d, content=<a href='/topic/show?id=c2c621665c4' target=_blank style='color:#2F92EE;'>#中国专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21665, encryptionId=c2c621665c4, topicName=中国专家共识)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=218a34934063, createdName=12498f1em19(暂无昵称), createdTime=Fri Mar 16 21:08:00 CST 2012, time=2012-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2691, encodeId=f25a2691f9, content=很有帮助，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c3c43454, createdName=evacai, createdTime=Tue Aug 09 19:39:00 CST 2011, time=2011-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2657, encodeId=1418265edc, content=有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=768c43348, createdName=ifaifa, createdTime=Sun Aug 07 11:41:00 CST 2011, time=2011-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289276, encodeId=515c12892e6a2, content=<a href='/topic/show?id=ede136018b' target=_blank style='color:#2F92EE;'>#BNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3601, encryptionId=ede136018b, topicName=BNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290322, encodeId=624f12903226b, content=<a href='/topic/show?id=f6e513111bc' target=_blank style='color:#2F92EE;'>#NT-proBNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13111, encryptionId=f6e513111bc, topicName=NT-proBNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601652, encodeId=0cca16016528b, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=)]
    2011-08-09 evacai

    很有帮助，谢谢！

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=37407, encodeId=e3f23e40729, content=Thanky Thanky for all this good inroomatifn!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=irfan, createdTime=Sun Sep 27 07:49:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835546, encodeId=63201835546b3, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Sat Apr 21 22:08:00 CST 2012, time=2012-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844373, encodeId=b1a018443e368, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sat Sep 17 21:08:00 CST 2011, time=2011-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741322, encodeId=981b1e413220d, content=<a href='/topic/show?id=c2c621665c4' target=_blank style='color:#2F92EE;'>#中国专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21665, encryptionId=c2c621665c4, topicName=中国专家共识)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=218a34934063, createdName=12498f1em19(暂无昵称), createdTime=Fri Mar 16 21:08:00 CST 2012, time=2012-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2691, encodeId=f25a2691f9, content=很有帮助，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c3c43454, createdName=evacai, createdTime=Tue Aug 09 19:39:00 CST 2011, time=2011-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2657, encodeId=1418265edc, content=有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=768c43348, createdName=ifaifa, createdTime=Sun Aug 07 11:41:00 CST 2011, time=2011-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289276, encodeId=515c12892e6a2, content=<a href='/topic/show?id=ede136018b' target=_blank style='color:#2F92EE;'>#BNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3601, encryptionId=ede136018b, topicName=BNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290322, encodeId=624f12903226b, content=<a href='/topic/show?id=f6e513111bc' target=_blank style='color:#2F92EE;'>#NT-proBNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13111, encryptionId=f6e513111bc, topicName=NT-proBNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601652, encodeId=0cca16016528b, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=)]
    2011-08-07 ifaifa

    有帮助

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=37407, encodeId=e3f23e40729, content=Thanky Thanky for all this good inroomatifn!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=irfan, createdTime=Sun Sep 27 07:49:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835546, encodeId=63201835546b3, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Sat Apr 21 22:08:00 CST 2012, time=2012-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844373, encodeId=b1a018443e368, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sat Sep 17 21:08:00 CST 2011, time=2011-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741322, encodeId=981b1e413220d, content=<a href='/topic/show?id=c2c621665c4' target=_blank style='color:#2F92EE;'>#中国专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21665, encryptionId=c2c621665c4, topicName=中国专家共识)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=218a34934063, createdName=12498f1em19(暂无昵称), createdTime=Fri Mar 16 21:08:00 CST 2012, time=2012-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2691, encodeId=f25a2691f9, content=很有帮助，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c3c43454, createdName=evacai, createdTime=Tue Aug 09 19:39:00 CST 2011, time=2011-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2657, encodeId=1418265edc, content=有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=768c43348, createdName=ifaifa, createdTime=Sun Aug 07 11:41:00 CST 2011, time=2011-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289276, encodeId=515c12892e6a2, content=<a href='/topic/show?id=ede136018b' target=_blank style='color:#2F92EE;'>#BNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3601, encryptionId=ede136018b, topicName=BNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290322, encodeId=624f12903226b, content=<a href='/topic/show?id=f6e513111bc' target=_blank style='color:#2F92EE;'>#NT-proBNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13111, encryptionId=f6e513111bc, topicName=NT-proBNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601652, encodeId=0cca16016528b, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=)]
    2011-06-25 huiwelcome

    #BNP#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=37407, encodeId=e3f23e40729, content=Thanky Thanky for all this good inroomatifn!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=irfan, createdTime=Sun Sep 27 07:49:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835546, encodeId=63201835546b3, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Sat Apr 21 22:08:00 CST 2012, time=2012-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844373, encodeId=b1a018443e368, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sat Sep 17 21:08:00 CST 2011, time=2011-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741322, encodeId=981b1e413220d, content=<a href='/topic/show?id=c2c621665c4' target=_blank style='color:#2F92EE;'>#中国专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21665, encryptionId=c2c621665c4, topicName=中国专家共识)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=218a34934063, createdName=12498f1em19(暂无昵称), createdTime=Fri Mar 16 21:08:00 CST 2012, time=2012-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2691, encodeId=f25a2691f9, content=很有帮助，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c3c43454, createdName=evacai, createdTime=Tue Aug 09 19:39:00 CST 2011, time=2011-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2657, encodeId=1418265edc, content=有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=768c43348, createdName=ifaifa, createdTime=Sun Aug 07 11:41:00 CST 2011, time=2011-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289276, encodeId=515c12892e6a2, content=<a href='/topic/show?id=ede136018b' target=_blank style='color:#2F92EE;'>#BNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3601, encryptionId=ede136018b, topicName=BNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290322, encodeId=624f12903226b, content=<a href='/topic/show?id=f6e513111bc' target=_blank style='color:#2F92EE;'>#NT-proBNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13111, encryptionId=f6e513111bc, topicName=NT-proBNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601652, encodeId=0cca16016528b, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=)]
    2011-06-25 mjldent

    #NT-proBNP#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=37407, encodeId=e3f23e40729, content=Thanky Thanky for all this good inroomatifn!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=irfan, createdTime=Sun Sep 27 07:49:00 CST 2015, time=2015-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835546, encodeId=63201835546b3, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Sat Apr 21 22:08:00 CST 2012, time=2012-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844373, encodeId=b1a018443e368, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Sat Sep 17 21:08:00 CST 2011, time=2011-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741322, encodeId=981b1e413220d, content=<a href='/topic/show?id=c2c621665c4' target=_blank style='color:#2F92EE;'>#中国专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21665, encryptionId=c2c621665c4, topicName=中国专家共识)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=218a34934063, createdName=12498f1em19(暂无昵称), createdTime=Fri Mar 16 21:08:00 CST 2012, time=2012-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2691, encodeId=f25a2691f9, content=很有帮助，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c3c43454, createdName=evacai, createdTime=Tue Aug 09 19:39:00 CST 2011, time=2011-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2657, encodeId=1418265edc, content=有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=768c43348, createdName=ifaifa, createdTime=Sun Aug 07 11:41:00 CST 2011, time=2011-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289276, encodeId=515c12892e6a2, content=<a href='/topic/show?id=ede136018b' target=_blank style='color:#2F92EE;'>#BNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3601, encryptionId=ede136018b, topicName=BNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290322, encodeId=624f12903226b, content=<a href='/topic/show?id=f6e513111bc' target=_blank style='color:#2F92EE;'>#NT-proBNP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13111, encryptionId=f6e513111bc, topicName=NT-proBNP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601652, encodeId=0cca16016528b, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Sat Jun 25 06:08:00 CST 2011, time=2011-06-25, status=1, ipAttribution=)]
    2011-06-25 sunylz

    #PRO#

    0

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