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Lancet Rheumatology: 疑似巨细胞动脉炎患者的血管超声诊断准确性(EUREKA):一项前瞻性、多中心、非干预性队列研究

2021-11-01 MedSci原创 MedSci原创

颞动脉活检被认为是诊断巨细胞动脉炎的金标准,尽管大约39%的活检阴性患者随后被诊断为巨细胞动脉炎。该研究旨在评估超声检查对疑似巨细胞动脉炎患者的诊断准确性。

     颞动脉活检被认为是诊断巨细胞动脉炎的金标准,尽管大约39%的活检阴性患者随后被诊断为巨细胞动脉炎。该研究旨在评估超声检查对疑似巨细胞动脉炎患者的诊断准确性。

     方法:在这项前瞻性、多中心、非干预性队列研究(评估超声在怀疑患有颅外和颅内巨细胞动脉炎患者中的作用;EUREKA)中,研究者连续招募了年龄在50岁或以上、在三个丹麦医院里怀疑患有巨细胞动脉炎的患者。参与者对颞动脉、面部动脉、颈总动脉和腋动脉进行了双侧超声检查。超声检查由接受过血管超声系统培训的超声医师使用适当的设备和设置完成。然后,参与者在开始皮质类固醇治疗后的7天内进行了颞动脉活检。由一位不知情的超声专家评估所有超声图像。颅动脉中的超声血管炎被定义为均匀的、低回声的内中膜复合体厚度和阳性压迫征,以及均匀的内中膜复合体厚度为1毫米或更宽的腋动脉和1.5毫米或更宽的颈总动脉。参与者在6个月时进行了随访。在这6个月期间,临床医生能够从所有临床检查中收集数据,以便在6个月时进行全面的临床诊断。临床诊断基于风湿病学家的意见。诊断标准为随访6个月确诊。使用逻辑回归分析来计算超声作为巨细胞动脉炎预测因子的优势比和95% CI

     结果:201441日至2017731日期间,对118名患者进行了筛选,其中 106名患者进行了超声检查和符合条件的颞动脉活检,并被纳入意向诊断人群。平均年龄为72.7(SD 7.9)63(59%)参与者为女性,43(41%)为男性。106名患者中有46 (43%)颞动脉活检呈阳性,62(58%)6个月时临床确诊为巨细胞动脉炎(颞动脉活检敏感性为74% [95% CI 6284 ],特异性100% [95% CI 92100]。所有颞动脉活检阳性患者的颅动脉超声均呈阳性,12例超声阳性而颞动脉活检阴性的患者中,有7例(58%)经其他影像学检查证实患有大血管巨细胞动脉炎。超声诊断巨细胞动脉炎的敏感性为94%84-98),特异性为84%70-93)。Logistic回归分析证实,超声是6个月时临床确诊巨细胞动脉炎的最强基线预测因子(粗比值比76.6 [95% CI 21.0280.0];调整性别和年龄后为141.0 [27.0743.0])。

     结论:血管超声由系统培训的超声医师使用适当的设备和环境进行的条件下可能有效地取代颞动脉活检,作为怀疑患有巨细胞动脉炎患者的一线诊断方法。

 

出处:

S. Chrysidis, U.M. Døhn, L. Terslev, U. Fredberg, T. Lorenzen, R. Christensen, K. Larsen, A.P. Diamantopoulos, Diagnostic accuracy of vascular ultrasound in patients with suspected giant cell arteritis (EUREKA): a prospective, multicentre, non-interventional, cohort study, The Lancet Rheumatology.

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attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560032, encodeId=1997156003258, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Wed Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=)]
    2022-05-18 howi
  4. [GetPortalCommentsPageByObjectIdResponse(id=2006539, encodeId=adcb20065393c, content=<a href='/topic/show?id=924a3264381' target=_blank style='color:#2F92EE;'>#前瞻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32643, encryptionId=924a3264381, topicName=前瞻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5cb32500112, createdName=1508842480_96220437, createdTime=Thu Dec 09 23:28:51 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700879, encodeId=e9011e00879af, content=<a href='/topic/show?id=e8a189e85e7' target=_blank style='color:#2F92EE;'>#血管超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89785, encryptionId=e8a189e85e7, topicName=血管超声)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=344130257146, createdName=shock_melon, createdTime=Sat Sep 03 05:28:51 CST 2022, time=2022-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831366, encodeId=41f01831366f3, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed May 18 09:28:51 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683224, encodeId=d21a16832243a, 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=50, replyNumber=0, topicName=null, topicId=null, 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09:28:51 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062564, encodeId=0def206256444, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Sat May 21 09:28:51 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502297, encodeId=c925150229e91, 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=57, 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 Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560032, encodeId=1997156003258, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Wed Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=)]
    2022-08-15 xsm927
  5. 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09:28:51 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062564, encodeId=0def206256444, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Sat May 21 09:28:51 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502297, encodeId=c925150229e91, 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=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], 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  6. [GetPortalCommentsPageByObjectIdResponse(id=2006539, encodeId=adcb20065393c, content=<a href='/topic/show?id=924a3264381' target=_blank style='color:#2F92EE;'>#前瞻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32643, encryptionId=924a3264381, topicName=前瞻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5cb32500112, createdName=1508842480_96220437, createdTime=Thu Dec 09 23:28:51 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700879, encodeId=e9011e00879af, content=<a href='/topic/show?id=e8a189e85e7' target=_blank style='color:#2F92EE;'>#血管超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89785, encryptionId=e8a189e85e7, topicName=血管超声)], attachment=null, authenticateStatus=null, createdAvatar=null, 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09:28:51 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062564, encodeId=0def206256444, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Sat May 21 09:28:51 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502297, encodeId=c925150229e91, 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=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], 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  7. [GetPortalCommentsPageByObjectIdResponse(id=2006539, encodeId=adcb20065393c, content=<a href='/topic/show?id=924a3264381' target=_blank style='color:#2F92EE;'>#前瞻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32643, encryptionId=924a3264381, topicName=前瞻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5cb32500112, createdName=1508842480_96220437, createdTime=Thu Dec 09 23:28:51 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700879, encodeId=e9011e00879af, content=<a href='/topic/show?id=e8a189e85e7' target=_blank style='color:#2F92EE;'>#血管超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89785, encryptionId=e8a189e85e7, topicName=血管超声)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=344130257146, createdName=shock_melon, createdTime=Sat Sep 03 05:28:51 CST 2022, time=2022-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831366, encodeId=41f01831366f3, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed May 18 09:28:51 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683224, encodeId=d21a16832243a, 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=50, 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=Mon Aug 15 18:28:51 CST 2022, time=2022-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1904091, encodeId=5fe0190409158, content=<a href='/topic/show?id=7d454302945' target=_blank style='color:#2F92EE;'>#多中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43029, encryptionId=7d454302945, topicName=多中心)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Thu Mar 17 14:28:51 CST 2022, time=2022-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1992913, encodeId=4cac19929131e, content=<a href='/topic/show?id=f68e9158034' target=_blank style='color:#2F92EE;'>#诊断准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91580, encryptionId=f68e9158034, topicName=诊断准确性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/pSGl6CJeZ2PzWxdhCtrvv4U9Q281RV8e0AKmlB5ib93DibbiaRyOzmkCdz5F04cbfX5RGOpG4dOXvuQW1fumibVeBg/132, createdBy=fc342500110, createdName=ms9833124466084992, createdTime=Sun May 08 06:28:51 CST 2022, time=2022-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1906007, encodeId=0086190600ebc, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Mon Jan 24 09:28:51 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062564, encodeId=0def206256444, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Sat May 21 09:28:51 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502297, encodeId=c925150229e91, 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=57, 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 Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560032, encodeId=1997156003258, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Wed Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=2006539, encodeId=adcb20065393c, content=<a href='/topic/show?id=924a3264381' target=_blank style='color:#2F92EE;'>#前瞻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32643, encryptionId=924a3264381, topicName=前瞻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5cb32500112, createdName=1508842480_96220437, createdTime=Thu Dec 09 23:28:51 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700879, encodeId=e9011e00879af, content=<a href='/topic/show?id=e8a189e85e7' target=_blank style='color:#2F92EE;'>#血管超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89785, encryptionId=e8a189e85e7, topicName=血管超声)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=344130257146, createdName=shock_melon, createdTime=Sat Sep 03 05:28:51 CST 2022, time=2022-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831366, encodeId=41f01831366f3, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed May 18 09:28:51 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683224, encodeId=d21a16832243a, 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=50, 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=Mon Aug 15 18:28:51 CST 2022, time=2022-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1904091, encodeId=5fe0190409158, content=<a href='/topic/show?id=7d454302945' target=_blank style='color:#2F92EE;'>#多中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43029, encryptionId=7d454302945, topicName=多中心)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Thu Mar 17 14:28:51 CST 2022, time=2022-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1992913, encodeId=4cac19929131e, content=<a href='/topic/show?id=f68e9158034' target=_blank style='color:#2F92EE;'>#诊断准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91580, encryptionId=f68e9158034, topicName=诊断准确性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/pSGl6CJeZ2PzWxdhCtrvv4U9Q281RV8e0AKmlB5ib93DibbiaRyOzmkCdz5F04cbfX5RGOpG4dOXvuQW1fumibVeBg/132, createdBy=fc342500110, createdName=ms9833124466084992, createdTime=Sun May 08 06:28:51 CST 2022, time=2022-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1906007, encodeId=0086190600ebc, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Mon Jan 24 09:28:51 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062564, encodeId=0def206256444, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Sat May 21 09:28:51 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502297, encodeId=c925150229e91, 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=57, 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 Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560032, encodeId=1997156003258, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Wed Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=2006539, encodeId=adcb20065393c, content=<a href='/topic/show?id=924a3264381' target=_blank style='color:#2F92EE;'>#前瞻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32643, encryptionId=924a3264381, topicName=前瞻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5cb32500112, createdName=1508842480_96220437, createdTime=Thu Dec 09 23:28:51 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700879, encodeId=e9011e00879af, content=<a href='/topic/show?id=e8a189e85e7' target=_blank style='color:#2F92EE;'>#血管超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89785, encryptionId=e8a189e85e7, topicName=血管超声)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=344130257146, createdName=shock_melon, createdTime=Sat Sep 03 05:28:51 CST 2022, time=2022-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831366, encodeId=41f01831366f3, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed May 18 09:28:51 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683224, encodeId=d21a16832243a, 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=50, replyNumber=0, topicName=null, topicId=null, 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09:28:51 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062564, encodeId=0def206256444, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Sat May 21 09:28:51 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502297, encodeId=c925150229e91, 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=57, 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 Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560032, encodeId=1997156003258, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Wed Nov 03 02:28:51 CST 2021, time=2021-11-03, status=1, ipAttribution=)]
    2021-11-03 wwzzly
  10. [GetPortalCommentsPageByObjectIdResponse(id=2006539, encodeId=adcb20065393c, content=<a href='/topic/show?id=924a3264381' target=_blank style='color:#2F92EE;'>#前瞻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32643, encryptionId=924a3264381, topicName=前瞻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5cb32500112, createdName=1508842480_96220437, createdTime=Thu Dec 09 23:28:51 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700879, encodeId=e9011e00879af, content=<a href='/topic/show?id=e8a189e85e7' target=_blank style='color:#2F92EE;'>#血管超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89785, encryptionId=e8a189e85e7, topicName=血管超声)], attachment=null, authenticateStatus=null, createdAvatar=null, 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