Stroke:AHA/ASA急性缺血性脑卒中静脉阿替普酶溶栓后出血性转化的治疗与预后的科学声明

2018-01-08 杨中华 脑血管病及重症文献导读

2017年12月Stroke杂志刊登了AHA和ASA的科学声明《急性缺血性卒中阿替普酶静脉溶栓后出血转化的治疗和预后》,现在摘录如下。


2017年12月Stroke杂志刊登了AHA和ASA的科学声明《急性缺血性卒中阿替普酶静脉溶栓后出血转化的治疗和预后》,现在摘录如下。

1.定义

目前采用的症状性颅内出血(sICH)定义差异很大,主要采用了出血的放射学分类和神经功能恶化的程度进行定义,当解释和报告sICH发生率需要考虑到这一点。为了能够与临床试验的数据进行比较,卒中中心应该按照出血转化的放射学标准(HI-1,HI-2,PH-1,PH-2,或远隔ICH)进行分类,并且需要采用NIHSS评分的变化评价神经功能恶化的程度,以及说明病情恶化的原因。

2.发生率

sICH定义的差异决定了sICH发生率存在差异,不同研究之间的差异在2.5到5倍之间。采用了临床实践经验的中心和专家的研究发现sICH发生率与临床试验的发生率相似。

3.危险因素与预测评分

sICH的危险评分有助于指导患者及家属的期望,有助于指导阿替普酶用药后医学监护的强度。高风险sICH患者仍然能够从阿替普酶溶栓中获益;因此,sICH预测评分和危险因素不应该作为筛选静脉溶栓患者的标准。

4.病理生理学

溶栓后出血转化的病理生理机制是多方面和相互关联的,包括缺血性损伤、凝血障碍、血脑屏障破坏和再灌注损伤。

5.诊断与检测

静脉溶栓所致sICH发生在溶栓药物输注后36h内,仅一半于输注阿替普酶后5-10h被诊断。神经和心血管功能监测从8h延长到12h(每30min一次)能够尽早诊断sICH,特别是高风险患者,但是需要大型前瞻性研究评价这个策略的成本效益。

随着卒中严重程度的增加,sICH引起的神经功能恶化可能不明显;因此,对于NIHSS评分较高的患者(例如NIHSS评分≥12分),可以考虑降低复查影像学检查的门槛。

6.自然史和预后

sICH患者的自然史很差,特别是PH-2型患者,死亡率和残疾率近50%。其他放射学出血亚型和预后之间的关系并不清楚;sICH合并缺血事件者预后更差。

7.治疗适应证

总体上,现有研究提示阿替普酶治疗24小时内sICH或伴有低纤维蛋白原血症者是治疗的适应症。治疗无症状性出血的数据是有限的,但是阿替普酶输注24h内任何无症状PH都可以考虑使用逆转药物,特别是存在凝血功能障碍者。

8.不同药物逆转凝血功能障碍

冷沉淀物:一旦确诊sICH,经治医生应立即送检纤维蛋白原水平,并且经验性地输注10U冷沉淀物,随后以纤维蛋白原>150mg/dl作为目标继续输注冷沉淀物。另外,应该首选冷沉淀物。该疗法仍需更多研究支持。

血小板输注:所有sICH患者输注血小板仍存在争议。血小板计数<100 000 /μL应考虑输注血小板。

凝血酶原复合物(PCC):使用PCC是有争议的,但对于溶栓之前接受了华法林治疗的患者,PCC可以作为冷沉淀物的辅助治疗方案。

新鲜冰冻血浆(FFP):使用FFP是有争议的,但对于溶栓之前接受了华法林治疗的患者,但当PCC不易获得时FFP可以作为冷沉淀的辅助治疗方案。

维生素K:使用维生素K是有争议的,但可以作为使用华法林治疗的患者的辅助治疗。

抗纤维蛋白溶解药:对于sICH患者,抗纤维蛋白溶解剂安全性和有效性数据是有限的。然而,所有sICH患者都可以考虑使用这类药物,特别是拒绝输注血液制品者。

重组活化凝血因子VIIa(rFVIIa):鉴于该治疗方法的潜在并发症,在没有更多研究证实其安全性的情况下不应使用rFVIIa。

9.血肿扩大的预防

应该权衡缺血恶化、出血严重程度和血肿扩大的风险,以制定血压的管理目标。对于血管再通不完全的患者,维持较高的血压目标值有助于维持足够的血流至缺血床,并降低梗死区域扩大的风险。另一方面,对于血管完全再通的患者,应考虑严格控制血压。这种措施的安全性和有效性仍需进一步研究。

10.神经外科治疗 

尽管存在缺血性损伤,如果手术能够改善sICH预后,可以考虑进行神经外科治疗。应仔细衡量手术获益和阿替普酶相关凝血功能障碍导致出血并发症的危害。

原始出处:


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 (9)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-09-08 fusion
  2. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-11-14 lvygwyt2781
  3. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-01-22 一个字-牛

    学习了谢谢分享

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-01-10 zhaohui6731
  9. [GetPortalCommentsPageByObjectIdResponse(id=1697613, encodeId=046b169e6135f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Sep 08 07:52:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858462, encodeId=dafb185846275, content=<a href='/topic/show?id=efd52810cc' target=_blank style='color:#2F92EE;'>#ASA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2810, encryptionId=efd52810cc, topicName=ASA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=947269, createdName=lvygwyt2781, createdTime=Wed Nov 14 20:52:00 CST 2018, time=2018-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022074, encodeId=6ed720220e4d3, content=<a href='/topic/show?id=b86f31465cc' target=_blank style='color:#2F92EE;'>#出血性转化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31465, encryptionId=b86f31465cc, topicName=出血性转化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47e62500168, createdName=ms1774076774505970, createdTime=Wed Apr 04 22:52:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807077, encodeId=d8d9180e0775b, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Dec 23 09:52:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892999, encodeId=04f4189299962, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Sep 06 14:52:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280897, encodeId=330628089e34, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Mon Jan 22 08:58:36 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259379, encodeId=c27512593e9d2, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267682, encodeId=3bec126e6825e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Jan 10 12:52:00 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276714, encodeId=6e722e671440, content=不错的文章不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Jan 08 22:54:58 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-01-08 1e1b8538m79(暂无匿称)

    不错的文章不错的文章

    0

相关资讯

Stroke:血清半乳凝素-3与急性缺血性脑卒中患者不良预后之间的关系!

由此可见,高水平的血清半乳凝素-3与卒中发病后死亡或严重残疾的风险增加独立相关,这表明半乳凝素-3可能在缺血性脑卒中患者预后不良具有预测价值。

2017 AHA/ASA科学声明:急性缺血性脑卒中静脉阿替普酶溶栓后出血性转化的治疗和结局

2017年11月,美国心脏协会(AHA)联合美国卒中协会(ASA)共同发布了关于急性缺血性脑卒中静脉阿替普酶溶栓后出血性转化的治疗和结局的科学声明。阿替普酶静脉溶栓后症状性颅内出血少见,却是严重并发症,快速诊断并早期纠正凝血障碍仍是主要治疗手段,缺血性卒中需要一步研究保持血脑屏障完整性,而后者立足于抑制基础生化过程。

Stroke:静脉溶栓治疗急性缺血性脑卒中后发生脑水肿的预测因素

脑水肿(CED)是急性缺血性卒中的严重并发症。脑梗死后发生CED的相关预测因素具有一定的不确定性。近期,一项发表在杂志Stroke上的研究旨在确定哪些基线临床和放射学参数能够预测使用静脉溶栓治疗的患者发生CED。研究者们在静脉溶栓成像扫描中使用了3度严重程度(不严重的CED 1和最严重的CED 3)的CED分类。在2002年至2011年期间,研究者们共从SITS国际注册中心(安全执行中风治疗)中记

Stroke:急性缺血性脑卒中在静脉溶栓术后出现脑水肿的预测因子!

脑水肿(CED)是急性缺血性脑卒中非常严重的并发症。尚无可靠的方法来预测在脑梗死后CED进展的指标。本研究为了验证利用基线时临床和影像学资料预测急性脑卒中静脉溶栓术的患者CED进展的可行性,并发表在STROKE上。

Eur Radiol:急性缺血性脑卒中后再灌注会增加血脑屏障破坏可逆性的几率

介于血液和脑组织之间的对物质通过有选择性阻碍作用的动态界面,由脑的连续毛细血管内皮及其细胞间的紧密连接、完整的基膜、周细胞以及星形胶质细胞脚板围成的神经胶质膜构成,其中内皮是血脑屏障的主要结构。本研究旨在发现有无再灌注的情况下,急性缺血性脑卒中(AIS)血脑屏障通透性(BBBP)的早期改变,以及是否BBBP能够预测临床预后,并将结果发表在Eur Radiol上。

急性缺血性脑卒中早期血管内介入治疗流程与规范专家共识

中华医学会神经病学分会等于2015 年发表了《中国急性缺血性脑卒中早期血管内介入诊疗指南》,从病例选择、治疗方式、围手术期管理等诸多方面对缺血性脑卒中早期血管内介入治疗进行了系统要求。但在我国由于各地区的医疗条件和水平存在较大差别,机械取栓设备和技术的推广也存在诸多限制,导致治疗效果的差别比较大。为进一步规范血管内治疗操作中的具体流程,文中进一步总结国内外近年研究结果,结合我国实际情况,拟完善一套