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JACC:PCI术后合并分叉病变,常规支架与专用分叉支架如何选择?

2015-02-24 张旭栋 MedSci原创

有症状的冠心病患者,在行径皮冠状动脉介入术后,经常会发生分叉病变,其比率接近15%-20%。尽管支架技术目前已经有了很大的进展,然而,分叉病变对于心脏疾病的介入治疗仍然是一项重大的挑战,其与围手术期心肌梗死,支架内血栓,远期再狭窄有着密切的联系。虽然已经有了很多对应的技术与治疗策略,目前的主流方案仍然是:主干病变首先治疗,分叉病变需要时再进行治疗。几项小的随机研究显示,对于




有症状的冠心病患者,在行径皮冠状动脉介入术后,经常会发生分叉病变,其比率接近15%-20%。尽管支架技术目前已经有了很大的进展,然而,分叉病变对于心脏疾病的介入治疗仍然是一项重大的挑战,其与围手术期心肌梗死,支架内血栓,远期再狭窄有着密切的联系。虽然已经有了很多对应的技术与治疗策略,目前的主流方案仍然是:主干病变首先治疗,分叉病变需要时再进行治疗。几项小的随机研究显示,对于分叉病变植入专用分叉支架具有一定的优势。加拿大魁北克蒙特利尔大学医学院,纽约哥伦比亚大学医学中心Philippe Généreux博士等人就此研究了常规支架(Provisional Stenting)与专用支架(Tryton Stent)的比较,成果发表在2月份Journal of the American College of Cardiology期刊上。
背景:有症状的冠心病患者经皮冠状动脉介入治疗后经常会出现分叉病变。对于侧枝的治疗,目前证据建议进行保守治疗(球囊扩张术后使用常规支架)。
目的:TRYTON(前瞻性,单盲,随机对照研究,以评估冠脉主枝和侧枝进行药物洗脱支架治疗的安全性和效益)分叉试验,旨在比较使用专用的分叉支架或侧枝球囊扩张术(扩张后使用常规支架)对于分叉病变的疗效。
方法:我们对植入主要血管支架后合并分叉病变的患者,随机行常规支架术或分叉支架术。主要终点为靶血管病变(TVF)(心源性死亡,靶血管心肌梗死和靶血管血运重建)。次要终点血管造影是9月后侧枝血管梗死直径的百分率。
结果:我们随机从58个中心选取704例具有冠脉分叉病变的患者(30个中心来自欧洲,28中心来自美国)。9个月后,分叉支架组TVF为17.4%与常规支架组为12.8%相比(p=0.11),围手术期心肌梗死率少许增高(13.6% vs. 10.1%, p = 0.19),但仍不具有显著优势。分叉支架组与常规支架组相比,侧枝梗死直径有所下降(31.6%:38.6%,P=0.002,有优势),而9个月随访显示,其再狭窄率无明显差异(直径狭窄≥50%)(22.6%:26.8%,P =0.44)。

结局:非左主干冠状动脉分叉病变中,常规支架仍然应该作为首选治疗策略。

原文出处:

Genereux P, Kumsars I, Lesiak M, Kini A, Fontos G, Slagboom T, Ungi I, Metzger DC, Wykrzykowska JJ, Stella PR, Bartorelli AL, Fearon WF, Lefevre T, Feldman RL, LaSalle L, Francese DP, Onuma Y, Grundeken MJ, Garcia-Garcia HM, Laak LL, Cutlip DE, Kaplan AV, Serruys PW, Leon MB. A randomized trial of a dedicated bifurcation stent versus provisional stenting in the treatment of coronary bifurcation lesions. Journal of the American College of Cardiology. 2015;65(6):533-43.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1853327, encodeId=2834185332e6b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu May 14 19:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633809, encodeId=923a163380952, content=<a href='/topic/show?id=578d13843ad' target=_blank style='color:#2F92EE;'>#PCI术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13843, encryptionId=578d13843ad, topicName=PCI术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea4322051797, createdName=zxl736, createdTime=Mon Jun 15 20:42:00 CST 2015, time=2015-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17960, encodeId=d9461e96011, content=很好,客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sun Mar 08 16:53:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325005, encodeId=a29d132500581, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486411, encodeId=12c41486411fd, content=<a href='/topic/show?id=76291384571' target=_blank style='color:#2F92EE;'>#PCI术后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13845, encryptionId=76291384571, topicName=PCI术后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ea78134582, createdName=12499e01m49暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557340, encodeId=02d3155e3406c, content=<a href='/topic/show?id=dd173153617' target=_blank style='color:#2F92EE;'>#分叉病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31536, encryptionId=dd173153617, topicName=分叉病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e47e14911964, createdName=sjzlzc012, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17000, encodeId=413e1e000d3, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Wed Feb 25 17:49:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16938, encodeId=7d4716938b2, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Tue Feb 24 23:32:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
    2015-05-14 hbwxf
  2. [GetPortalCommentsPageByObjectIdResponse(id=1853327, encodeId=2834185332e6b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu May 14 19:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633809, encodeId=923a163380952, content=<a href='/topic/show?id=578d13843ad' target=_blank style='color:#2F92EE;'>#PCI术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13843, encryptionId=578d13843ad, topicName=PCI术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea4322051797, createdName=zxl736, createdTime=Mon Jun 15 20:42:00 CST 2015, time=2015-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17960, encodeId=d9461e96011, content=很好,客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sun Mar 08 16:53:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325005, encodeId=a29d132500581, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486411, encodeId=12c41486411fd, content=<a href='/topic/show?id=76291384571' target=_blank style='color:#2F92EE;'>#PCI术后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13845, encryptionId=76291384571, topicName=PCI术后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ea78134582, createdName=12499e01m49暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557340, encodeId=02d3155e3406c, content=<a href='/topic/show?id=dd173153617' target=_blank style='color:#2F92EE;'>#分叉病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31536, encryptionId=dd173153617, topicName=分叉病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e47e14911964, createdName=sjzlzc012, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17000, encodeId=413e1e000d3, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Wed Feb 25 17:49:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16938, encodeId=7d4716938b2, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Tue Feb 24 23:32:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
    2015-06-15 zxl736
  3. [GetPortalCommentsPageByObjectIdResponse(id=1853327, encodeId=2834185332e6b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu May 14 19:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633809, encodeId=923a163380952, content=<a href='/topic/show?id=578d13843ad' target=_blank style='color:#2F92EE;'>#PCI术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13843, encryptionId=578d13843ad, topicName=PCI术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea4322051797, createdName=zxl736, createdTime=Mon Jun 15 20:42:00 CST 2015, time=2015-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17960, encodeId=d9461e96011, content=很好,客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sun Mar 08 16:53:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325005, encodeId=a29d132500581, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486411, encodeId=12c41486411fd, content=<a href='/topic/show?id=76291384571' target=_blank style='color:#2F92EE;'>#PCI术后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13845, encryptionId=76291384571, topicName=PCI术后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ea78134582, createdName=12499e01m49暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557340, encodeId=02d3155e3406c, content=<a href='/topic/show?id=dd173153617' target=_blank style='color:#2F92EE;'>#分叉病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31536, encryptionId=dd173153617, topicName=分叉病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e47e14911964, createdName=sjzlzc012, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17000, encodeId=413e1e000d3, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Wed Feb 25 17:49:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16938, encodeId=7d4716938b2, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Tue Feb 24 23:32:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
    2015-03-08 drhqh240

    很好,客观

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1853327, encodeId=2834185332e6b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu May 14 19:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633809, encodeId=923a163380952, content=<a href='/topic/show?id=578d13843ad' target=_blank style='color:#2F92EE;'>#PCI术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13843, encryptionId=578d13843ad, topicName=PCI术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea4322051797, createdName=zxl736, createdTime=Mon Jun 15 20:42:00 CST 2015, time=2015-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17960, encodeId=d9461e96011, content=很好,客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sun Mar 08 16:53:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325005, encodeId=a29d132500581, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486411, encodeId=12c41486411fd, content=<a href='/topic/show?id=76291384571' target=_blank style='color:#2F92EE;'>#PCI术后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13845, encryptionId=76291384571, topicName=PCI术后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ea78134582, createdName=12499e01m49暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557340, encodeId=02d3155e3406c, content=<a href='/topic/show?id=dd173153617' target=_blank style='color:#2F92EE;'>#分叉病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31536, encryptionId=dd173153617, topicName=分叉病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e47e14911964, createdName=sjzlzc012, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17000, encodeId=413e1e000d3, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Wed Feb 25 17:49:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16938, encodeId=7d4716938b2, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Tue Feb 24 23:32:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1853327, encodeId=2834185332e6b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu May 14 19:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633809, encodeId=923a163380952, content=<a href='/topic/show?id=578d13843ad' target=_blank style='color:#2F92EE;'>#PCI术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13843, encryptionId=578d13843ad, topicName=PCI术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea4322051797, createdName=zxl736, createdTime=Mon Jun 15 20:42:00 CST 2015, time=2015-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17960, encodeId=d9461e96011, content=很好,客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sun Mar 08 16:53:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325005, encodeId=a29d132500581, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486411, encodeId=12c41486411fd, content=<a href='/topic/show?id=76291384571' target=_blank style='color:#2F92EE;'>#PCI术后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13845, encryptionId=76291384571, topicName=PCI术后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ea78134582, createdName=12499e01m49暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557340, encodeId=02d3155e3406c, content=<a href='/topic/show?id=dd173153617' target=_blank style='color:#2F92EE;'>#分叉病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31536, encryptionId=dd173153617, topicName=分叉病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e47e14911964, createdName=sjzlzc012, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17000, encodeId=413e1e000d3, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Wed Feb 25 17:49:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16938, encodeId=7d4716938b2, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Tue Feb 24 23:32:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1853327, encodeId=2834185332e6b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu May 14 19:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633809, encodeId=923a163380952, content=<a href='/topic/show?id=578d13843ad' target=_blank style='color:#2F92EE;'>#PCI术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13843, encryptionId=578d13843ad, topicName=PCI术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea4322051797, createdName=zxl736, createdTime=Mon Jun 15 20:42:00 CST 2015, time=2015-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17960, encodeId=d9461e96011, content=很好,客观, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sun Mar 08 16:53:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325005, encodeId=a29d132500581, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486411, encodeId=12c41486411fd, content=<a href='/topic/show?id=76291384571' target=_blank style='color:#2F92EE;'>#PCI术后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13845, encryptionId=76291384571, topicName=PCI术后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ea78134582, createdName=12499e01m49暂无昵称, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557340, encodeId=02d3155e3406c, content=<a href='/topic/show?id=dd173153617' target=_blank style='color:#2F92EE;'>#分叉病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31536, encryptionId=dd173153617, topicName=分叉病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e47e14911964, createdName=sjzlzc012, createdTime=Thu Feb 26 12:42:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17000, encodeId=413e1e000d3, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Wed Feb 25 17:49:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16938, encodeId=7d4716938b2, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Tue Feb 24 23:32:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
    2015-02-25 orthoW

    不错的文章,学习了

    0

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    2015-02-24 hbwang006

    明白了

    0

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