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T波深倒置的鉴别诊断:从心电图到超声

2020-07-16 孔令秋 孔较瘦

本文通过一个误诊多年的病例,结合超声和心电图,介绍一下在心电图在T波鉴别诊断中存在的一些问题,以及我个人的一些思考。

波倒置是一种十分常见的心电图异常,其中T波深倒置病因漏诊、误诊不在少数。凡是影响心肌复极的疾病,如心肌肥厚、肺栓塞、心肌缺血等都可以导致T波深倒置。

不同疾病影响T波深度不同,累及导联不同,有的会出现动态变化,有的则不会。因心电图比较敏感,在遇到这类心电图异常后,应提醒影像医生重点观察心肌有无肥厚,结合冠脉造影等进行病因学筛查

本文通过一个误诊多年的病例,结合超声和心电图,介绍一下在心电图在T波鉴别诊断中存在的一些问题,以及我个人的一些思考。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
    2021-05-09 暴走的小护士

    很好

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
    2020-11-07 12412355m93暂无昵称

    学习了,还少一个心律失常性右心室发育不良。

    0

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    2020-10-29 1482f88bm16暂无昵称

    受用

    0

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    2020-10-26 narutohokage

    不错,很实用

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
    2020-10-02 ms6000001136183965

    学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
    2020-09-25 ms7000000628043919

    很实用。

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
    2020-09-19 147734a1m19暂无昵称

    学习了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
    2020-09-04 124d9e69m07暂无昵称

    学习了

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=963946, encodeId=34d3963946f9, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210509/f70995742d7d4c188bb029cc5df4dd62/72b43a1726e14c5999eccebd4162a5a8.jpg, createdBy=d0115496127, createdName=暴走的小护士, createdTime=Sun May 09 13:04:49 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897519, encodeId=d61189e51996, content=学习了,还少一个心律失常性右心室发育不良。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7572458878, createdName=12412355m93暂无昵称, createdTime=Sat Nov 07 09:57:59 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=895511, encodeId=a4358955115d, content=受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d235275221, createdName=1482f88bm16暂无昵称, createdTime=Thu Oct 29 21:20:32 CST 2020, time=2020-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=894475, encodeId=57708944e51d, content=不错,很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201025/6855c11d03d14ffe9821c390a8212f6a/4a122e6cdf4f4857a3a1ced2063770bd.jpg, createdBy=0ce587510, createdName=narutohokage, createdTime=Mon Oct 26 08:27:41 CST 2020, time=2020-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=893427, encodeId=f13289342e1f, content=<a href='/topic/show?id=8f2310398238' target=_blank style='color:#2F92EE;'>#本末倒置#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103982, encryptionId=8f2310398238, topicName=本末倒置)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200828/5ead122f9ace4344b58402de23c9289a/ba455281a1d84c4fa6feaa6689f0898b.jpg, createdBy=80c12474234, createdName=Arvin0001, createdTime=Wed Oct 21 00:23:11 CST 2020, time=2020-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=889675, encodeId=dcda8896e54e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97be5414604, createdName=ms6000001136183965, createdTime=Fri Oct 02 11:22:17 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888165, encodeId=541d8881651d, content=很实用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dcf35421413, createdName=ms7000000628043919, createdTime=Fri Sep 25 08:39:34 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886711, encodeId=0e1f886e1163, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd65217930, createdName=147734a1m19暂无昵称, createdTime=Sat Sep 19 21:09:52 CST 2020, time=2020-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=882650, encodeId=76bc88265084, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=94642520177, createdName=124d9e69m07暂无昵称, createdTime=Fri Sep 04 09:25:34 CST 2020, time=2020-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813232, encodeId=65898132326b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/ibz2HQeVQM6BfkEWaWQnF5wn92jyroX7o8zcXA5JRbIfDHk4I39OsU1PhZKnvPhEN6sk3J8TenMibxGL68HMfTew/132, createdBy=92555321953, createdName=anne1023, createdTime=Tue Aug 25 22:56:07 CST 2020, time=2020-08-25, status=1, ipAttribution=)]
    2020-08-25 anne1023

    不错

    0

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