Baidu
map

诊断巨细胞动脉炎:颞动脉活检优于ACR标准

2012-08-13 不详 网络

    根据一项针对美国风湿病学会(ACR)巨细胞动脉炎(GCA)诊断指南临床应用的回顾性病例研究结果,现行标准的敏感性和特异性均较低,不宜作为临床诊断依据(Am. J. Ophthalmol. 2012 July 20 [doi:10.1016/j.ajo.2012.03.045])。    费城威尔士眼科研究所的Ann P. Murc

    根据一项针对美国风湿病学会(ACR)巨细胞动脉炎(GCA)诊断指南临床应用的回顾性病例研究结果,现行标准的敏感性和特异性均较低,不宜作为临床诊断依据(Am. J. Ophthalmol. 2012 July 20 [doi:10.1016/j.ajo.2012.03.045])。
    费城威尔士眼科研究所的Ann P. Murchison博士及其同事认为,1990年发布的现行ACR 标准不应作为确诊GCA的依据,建议对所有GCA疑似患者应进行至少2 cm的颞动脉活检,所有活检阳性患者均应接受全身类固醇药物治疗,即使不符合ACR标准中的其他条件。同时还建议所有GCA治疗医生应了解颞动脉活检对于GCA诊断的重要性,应将活检结果作为CGA研究的唯一确诊指标,而非ACR标准。作者介绍,经常被用于GCA诊断的现行ACR标准并没有将阳性活检结果作为确诊的必要条件。该标准规定,如果患者符合下列5项标准中的3项即可确诊为GCA:年龄>50岁,新发局部头痛,颞动脉触痛或搏动减弱,ESR(血沉)≥50 mm/h,或颞静脉活检阳性。
    研究者查阅了2001年10月~2006年行颞动脉活检的112例GCA疑似患者的病历,考察是否符合ACR诊断标准、活检结果以及患者确诊后视力下降进展情况。在112例患者中,74例符合分析纳入标准,其中35例活检阳性,39例活检阴性。排除标准为诊断前接受类固醇药物治疗和活检样本长度<2 cm。
    在35例活检阳性患者中,9例(25.7%)符合ACR标准中的2项(年龄>50岁和活检阳性)。虽然这些患者活检结果阳性,但如果仅依据ACR标准则不能诊断为GCA,因而也不会进行活检或治疗,从而面临灾难性失明的高度风险。16例(4.7%)在活检前符合2项ACR标准,需要行活检以便确诊。其余10例(28.5%)在活检前符合3项或4项ACR标准。
    在29例活检阴性患者中,11例(28.2%)符合3项或4项ACR标准。对于这些患者,如果仅以ACR标准(不行活检)作为诊断标准,他们将接受类固醇药物治疗,会因长期使用类固醇而面临潜在不良事件。17例(43.6%)符合2项标准,但因活检阴性而被排除GCA。其余11例(28.2%)符合1项标准,因此按照ACR标准,活检结果将不会改变诊断结果。
    根据研究者计算结果,ACR标准的敏感性和特异性分别为74.3%和71.8%。如果不考虑活检结果,敏感性会降至28.6%。研究者指出,上述结果明显低于1990年ACR所引用的敏感性(93.5%)和特异性(91.2%)数据。
    作者指出,对于ACR标准可靠性的质疑并非首次出现。既往研究显示,无论该标准中的任意一项,还是综合所有各项,其敏感性或特异性均不及颞动脉活检。然而,部分医生仍没有将颞动脉活检作为诊断GCA的必要条件。
    作者报告无经济利益冲突。

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 (6)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1820333, encodeId=4f7618203330b, content=<a href='/topic/show?id=f916100e7446' target=_blank style='color:#2F92EE;'>#颞动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100774, encryptionId=f916100e7446, topicName=颞动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jun 12 20:11:00 CST 2013, time=2013-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683155, encodeId=fa761683155a8, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Tue Jan 08 23:11:00 CST 2013, time=2013-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778994, encodeId=21741e789943d, content=<a href='/topic/show?id=2e6c188190' target=_blank style='color:#2F92EE;'>#ACR标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1881, encryptionId=2e6c188190, topicName=ACR标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Sat Jul 20 06:11:00 CST 2013, time=2013-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277930, encodeId=4f0b12e793078, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400270, encodeId=d1f814002e0fe, content=<a href='/topic/show?id=e7c018e7af' target=_blank style='color:#2F92EE;'>#ACR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1877, encryptionId=e7c018e7af, topicName=ACR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19792261142, createdName=10518094zz, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502161, encodeId=539d150216179, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=)]
    2013-06-12 sunylz
  2. [GetPortalCommentsPageByObjectIdResponse(id=1820333, encodeId=4f7618203330b, content=<a href='/topic/show?id=f916100e7446' target=_blank style='color:#2F92EE;'>#颞动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100774, encryptionId=f916100e7446, topicName=颞动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jun 12 20:11:00 CST 2013, time=2013-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683155, encodeId=fa761683155a8, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Tue Jan 08 23:11:00 CST 2013, time=2013-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778994, encodeId=21741e789943d, content=<a href='/topic/show?id=2e6c188190' target=_blank style='color:#2F92EE;'>#ACR标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1881, encryptionId=2e6c188190, topicName=ACR标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Sat Jul 20 06:11:00 CST 2013, time=2013-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277930, encodeId=4f0b12e793078, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400270, encodeId=d1f814002e0fe, content=<a href='/topic/show?id=e7c018e7af' target=_blank style='color:#2F92EE;'>#ACR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1877, encryptionId=e7c018e7af, topicName=ACR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19792261142, createdName=10518094zz, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502161, encodeId=539d150216179, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=)]
    2013-01-08 xsm927
  3. [GetPortalCommentsPageByObjectIdResponse(id=1820333, encodeId=4f7618203330b, content=<a href='/topic/show?id=f916100e7446' target=_blank style='color:#2F92EE;'>#颞动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100774, encryptionId=f916100e7446, topicName=颞动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jun 12 20:11:00 CST 2013, time=2013-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683155, encodeId=fa761683155a8, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Tue Jan 08 23:11:00 CST 2013, time=2013-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778994, encodeId=21741e789943d, content=<a href='/topic/show?id=2e6c188190' target=_blank style='color:#2F92EE;'>#ACR标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1881, encryptionId=2e6c188190, topicName=ACR标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Sat Jul 20 06:11:00 CST 2013, time=2013-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277930, encodeId=4f0b12e793078, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400270, encodeId=d1f814002e0fe, content=<a href='/topic/show?id=e7c018e7af' target=_blank style='color:#2F92EE;'>#ACR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1877, encryptionId=e7c018e7af, topicName=ACR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19792261142, createdName=10518094zz, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502161, encodeId=539d150216179, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1820333, encodeId=4f7618203330b, content=<a href='/topic/show?id=f916100e7446' target=_blank style='color:#2F92EE;'>#颞动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100774, encryptionId=f916100e7446, topicName=颞动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jun 12 20:11:00 CST 2013, time=2013-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683155, encodeId=fa761683155a8, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Tue Jan 08 23:11:00 CST 2013, time=2013-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778994, encodeId=21741e789943d, content=<a href='/topic/show?id=2e6c188190' target=_blank style='color:#2F92EE;'>#ACR标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1881, encryptionId=2e6c188190, topicName=ACR标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Sat Jul 20 06:11:00 CST 2013, time=2013-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277930, encodeId=4f0b12e793078, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400270, encodeId=d1f814002e0fe, content=<a href='/topic/show?id=e7c018e7af' target=_blank style='color:#2F92EE;'>#ACR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1877, encryptionId=e7c018e7af, topicName=ACR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19792261142, createdName=10518094zz, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502161, encodeId=539d150216179, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=)]
    2012-08-15 smlt2008
  5. [GetPortalCommentsPageByObjectIdResponse(id=1820333, encodeId=4f7618203330b, content=<a href='/topic/show?id=f916100e7446' target=_blank style='color:#2F92EE;'>#颞动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100774, encryptionId=f916100e7446, topicName=颞动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jun 12 20:11:00 CST 2013, time=2013-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683155, encodeId=fa761683155a8, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Tue Jan 08 23:11:00 CST 2013, time=2013-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778994, encodeId=21741e789943d, content=<a href='/topic/show?id=2e6c188190' target=_blank style='color:#2F92EE;'>#ACR标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1881, encryptionId=2e6c188190, topicName=ACR标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Sat Jul 20 06:11:00 CST 2013, time=2013-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277930, encodeId=4f0b12e793078, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400270, encodeId=d1f814002e0fe, content=<a href='/topic/show?id=e7c018e7af' target=_blank style='color:#2F92EE;'>#ACR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1877, encryptionId=e7c018e7af, topicName=ACR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19792261142, createdName=10518094zz, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502161, encodeId=539d150216179, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=)]
    2012-08-15 10518094zz
  6. [GetPortalCommentsPageByObjectIdResponse(id=1820333, encodeId=4f7618203330b, content=<a href='/topic/show?id=f916100e7446' target=_blank style='color:#2F92EE;'>#颞动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100774, encryptionId=f916100e7446, topicName=颞动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Jun 12 20:11:00 CST 2013, time=2013-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683155, encodeId=fa761683155a8, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Tue Jan 08 23:11:00 CST 2013, time=2013-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778994, encodeId=21741e789943d, content=<a href='/topic/show?id=2e6c188190' target=_blank style='color:#2F92EE;'>#ACR标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1881, encryptionId=2e6c188190, topicName=ACR标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Sat Jul 20 06:11:00 CST 2013, time=2013-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277930, encodeId=4f0b12e793078, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400270, encodeId=d1f814002e0fe, content=<a href='/topic/show?id=e7c018e7af' target=_blank style='color:#2F92EE;'>#ACR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1877, encryptionId=e7c018e7af, topicName=ACR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19792261142, createdName=10518094zz, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502161, encodeId=539d150216179, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed Aug 15 07:11:00 CST 2012, time=2012-08-15, status=1, ipAttribution=)]
    2012-08-15 wwzzly
Baidu
map
Baidu
map
Baidu
map