冠脉造影正常,凭什么说心梗?

2018-01-30 黄一林 医学界心血管频道

心梗的主要病因在冠状动脉粥样硬化病变的基础上,不稳定斑块破裂诱发血栓堵塞血管所致。但还有10%~15%的心梗发生在冠状动脉造影无明显异常及一些非动脉粥样硬化性疾病的患者。

心梗的主要病因在冠状动脉粥样硬化病变的基础上,不稳定斑块破裂诱发血栓堵塞血管所致。但还有10%~15%的心梗发生在冠状动脉造影无明显异常及一些非动脉粥样硬化性疾病的患者。

今天,一位40岁男性患者因持续性胸痛4小时前来检查,心电图II、III、aVF导联ST段抬高0.3 mv,初诊为急性心肌梗死收入院。可做了冠脉造影后,发现仅有右冠状动脉近段斑块浸润,随后告知家属造影结果正常。

家属和病人听后十分不理解:造影正常,凭什么说我是心梗?

现如今,冠状动脉造影作为检查急性心肌梗死患者心血管状况的金标准,已经被普遍接受。AMI的主要病因在冠状动脉粥样硬化病变的基础上,不稳定斑块破裂诱发血栓堵塞血管所致,但还有10%~15%的AMI发生在冠状动脉造影无明显异常及一些非动脉粥样硬化性疾病的患者[1]。

冠脉造影正常但发生心梗的可能机制包括以下几点:

1、冠状动脉痉挛

冠状动脉持续性痉挛可以使冠状动脉急性闭塞,长时间的冠状动脉痉挛可造成血管内皮的损伤,从而继发血小板的聚集和原位血栓的形成;而在血栓形成的过程中释放缩血管的物质又进一步促进了冠脉的痉挛[2]。

导致冠脉痉挛的因素有很多,吸烟、交感神经兴奋、某些药物作用(如甲状腺激素、麻醉药物、甲基麦角新碱、滥用可卡因等)均可导致冠脉痉挛,并有上述因素引发急性心肌梗死的报道。其中最主要的因素是长期大量的吸烟,有大量研究显示,吸烟成为冠状动脉造影正常、急性心肌梗死的重要危险因素[3]。

2、冠状动脉心肌桥

冠状动脉心肌桥是一种先天性的冠状动脉发育异常。冠状动脉主干及其分支通常行走于心脏表面的心外膜下脂肪中或心外膜深面。然而,在冠状动脉发育过程中,冠状动脉或其分支的某个节段可被浅层心肌覆盖,在心肌内走行,被心肌覆盖的冠状动脉段称壁冠状动脉,覆盖在冠状动脉上的心肌称为心肌桥(myocardialbridge,MB)。

心肌桥可能与冠心病的发病局部因素有关,近年发现,心肌桥对冠状动脉的收缩期压迫不仅导致收缩期心肌血流灌注减少,而且舒张早、中期心肌灌注也受到影响,导致心肌缺血。

有研究发现,心肌桥患者中部分患者的症状类似冠心病,主要表现为胸闷、胸痛等心肌缺血、心绞痛症状,有时伴有心律失常表现为心悸,严重而持久的心肌缺血可致心肌梗死,甚至猝死。部分患者心电图呈缺血性改变,且症状发作时有ST-T弓背样抬高及相应的动态改变,较正常人有特异性区别[4]。

3、微血管病变导致心肌局灶性坏死

临床上有10%~30%的存在心绞痛症状的患者接受冠脉造影后提示冠脉正常,被认为是微血管性心绞痛(心脏X综合征),多见于围绝经期女性。

微血管病变的机制可能由于微血管内皮功能不良、微血管痉挛以及交感张力增强等因素。当这些因素发生时,会导致冠脉血流储备不足,从而引发心绞痛症状,严重者可能会造成局部心肌梗死。

有研究示,冠状动脉造影正常,临床上有缺血性ST-T改变者中有80%多的患者存在相应的冠脉血流储备(CFR)功能降低,提示存在冠脉微血管病变[5]。

4、应激性心肌病

应激性心肌病(又称心尖球形综合征)的临床特征为应激诱发的剧烈胸痛,酷似急性心肌梗死样。

心电图表现为ST段抬高、 T波倒置、QT间期延长;心肌酶学可以有轻到中度升高;心脏超声表现为短暂的左室心尖一中段气球样改变,运动减弱伴基底段收缩力增强。冠状动脉造影未见明显狭窄,心室造影提示收缩末期可见左室心尖一中段的心腔扩大、基底段缩窄。病因尚不清楚,大多数病人预后良好。

5、冠脉内急性血栓自溶或溶栓后血栓消失

有研究发现急性心肌梗死患者的动脉粥样硬化情况并不重,这部分患者冠脉造影正常,但可能心肌梗死之前血管存在一些微小斑块,在斑块的发展过程中,部分稳定斑块变得不稳定,发生破裂;由于管腔狭窄轻,没有形成充足的侧支循环,一旦破裂导致内膜损伤、内膜下胶原纤维暴露等,可促进血小板聚集,形成微血栓。

但在形成血栓的同时,纤溶系统也会启动,造成血栓的早期自溶,因此一部分急性心肌梗死患者尚存在血栓自溶的过程。加上积极抗凝溶栓治疗,冠脉造影也可能正常。

6、其他

栓子脱落、心肌氧的供需失衡、冠状动脉血管炎、先天性冠状动脉异常、主动脉夹层动脉瘤等。非动脉粥样硬化因素同样可引起严重的冠状动脉狭窄,并可引起不稳定型心绞痛、急性心肌梗死或心脏性猝死。

冠脉造影正常的心肌梗死患者的远期预后可能要比冠心病所致的心梗好,但是绝不能因为冠脉造影正常就掉以轻心。部分冠脉造影正常的患者,也许是更高危人群,在临床上应引起我们的高度重视。

原始出处:

1.Alpert,JS. Myocardial  infarction with angiographically normal coronary arteries[J].Arch Intern Med,1994,154:265-269


3.季福绥,范海荣,许锋,等.冠状动脉造影正常的急性心肌梗死病例临床分析[J].中国医刊,2004,39(5):32-33

4.何文一,张冬颖,77例冠脉造影心肌桥患者的临床特点和治疗效果分析[J].重庆医学,2011,40(29):2973-2975.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (28)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-02-04 lou.minghong

    诊断越来越依赖于仪器.必然会产生类似的疑问.

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-02-02 三生有幸9135

    学习一下谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-02-01 lou.minghong

    学习谢谢分享!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-02-01 sodoo
  5. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-02-01 chunjianf

    学习了.谢谢分享

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-01-31 sunfeifeiyang

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-01-31 120e71dcm28暂无昵称

    涨见识了.谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-01-31 120e71dcm28暂无昵称

    很详细.非常好.谢谢

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=284991, encodeId=4715284991f1, content=诊断越来越依赖于仪器.必然会产生类似的疑问., beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 04 09:37:28 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284321, encodeId=4ac12843211f, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Feb 02 05:00:42 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284195, encodeId=69a9284195f8, content=学习谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Thu Feb 01 17:34:23 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494063, encodeId=dc8c1494063b1, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447192, encodeId=11d3144e192c3, content=<a href='/topic/show?id=dd2f31009da' target=_blank style='color:#2F92EE;'>#冠脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31009, encryptionId=dd2f31009da, topicName=冠脉造影)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=l9h0OhA0BicNC4kpEUl4AeA&s=100&t=1587635346, createdBy=61865326685, createdName=李研东, createdTime=Thu Feb 01 14:31:00 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284063, encodeId=ef3d28406330, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Thu Feb 01 06:40:21 CST 2018, time=2018-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283864, encodeId=1a4828386457, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Jan 31 14:52:58 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283829, encodeId=f1a928382974, content=涨见识了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:29:18 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283828, encodeId=1336283828cd, content=很详细.非常好.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Wed Jan 31 12:25:33 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283800, encodeId=20b3283800da, content=学习了谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Wed Jan 31 09:45:38 CST 2018, time=2018-01-31, status=1, ipAttribution=)]
    2018-01-31 186****0580(小山羊)

    学习了谢谢了

    0

相关资讯

冠脉造影正常,就万事大吉了?

冠脉造影是目前诊断冠心病的“金标准”,这一里程碑式的检查使冠心病诊断快速又准确,以至于使其他诊断冠心病的检查手段(如运动平板试验等)黯然失色。

冠脉造影 VS 双源CT冠脉成像,究竟孰优孰劣?

如今,双源CT冠脉成像因其独特优势而备受瞩目,但冠脉造影仍是当仁不让,占据“金标准”的宝座,但因其风险较高而不被大众所接受。

Heart:冠脉造影与心衰的预后有关?

对于较严重的心衰患者,往往会行冠脉造影术,然而,心衰患者冠状动脉造影术的决定因素和相关临床结果知之甚少。 本研究(BIOSTAT-CHF)纳入了2516名有明显临床症状的心衰患者,包括住院治疗的病人和院外治疗的患者。研究结果显示,有315名(12.5%)心衰患者在出现了明显临床症状后30天内接受了冠脉造影术。在接受了冠脉造影的患者中,大多数是住院病人,伴有较明显的急性冠脉综合征,肌钙蛋白I的

Radiology:等渗好还是低渗好?碘克沙醇和碘普罗胺在冠状动脉CT血管成像的显影效果。

离子型:离子型造影剂按结构分为单酸单体和单酸二聚体。单酸单体的代表药物有泛影葡胺(可用于各种血管造影及静脉肾孟造影。用于不同器官时,其浓度亦不同)、碘他拉葡胺等。离子型造影剂的副反应发生率高,肌体的耐受性差。非离子型碘造影剂较离子型毒副作用小,可用于各种血管造影及经血管的造影检查。非离子型造影剂副反应发生率低,肌体的耐受性好。本研究为了验证在以相同碘注射率的条件下注射相同或较低剂量的对比剂时通过C

病例分享:八旬老妇冠脉造影突然意识丧失,左肢肌力为0,原来是“它”在搞事情

患者在行冠脉造影过程中20分钟时,欲拔除动脉导管时患者出现意识丧失,左侧肢体肌力为0,双眼向右侧凝视。

JAHA:冠脉手术后的桡动脉和尺动脉阻塞以及抗凝治疗的影响

RAO和UAO发生频率相似,当冠脉手术后进行血管超声早期评估时大约为7%-8%。