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Eur Heart J：射血分数降低的心衰患者：ACEI、ARB或β-受体阻断剂剂量减少后果很严重

2017-08-03 安雅晶 环球医学资讯

射血分数降低心衰患者ACEIARBβ-受体阻断剂
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尽管有指南明确推荐，但大多数心衰且射血分数降低（HFrEF）患者未达到指南推荐的ACE抑制剂/血管紧张素受体阻断剂（ARB）和/或β-受体阻断剂目标剂量。2017年，发表在《Eur Heart J》的一项研究显示，小于50%推荐剂量的HFrEF患者似乎具有较大的死亡和/或心衰住院风险。

尽管有指南明确推荐，但大多数心衰且射血分数降低（HFrEF）患者未达到指南推荐的ACE抑制剂/血管紧张素受体阻断剂（ARB）和/或β-受体阻断剂目标剂量。2017年，发表在《Eur Heart J》的一项研究显示，小于50%推荐剂量的HFrEF患者似乎具有较大的死亡和/或心衰住院风险。

背景：尽管有指南明确推荐，但大多数心衰且射血分数降低（HFrEF）患者未达到指南推荐的目标剂量。研究者旨在调查未达到ACE抑制剂/血管紧张素受体阻断剂（ARB）和/或β-受体阻断剂治疗推荐剂量的HFrEF患者特征和校正治疗适应症偏倚的临床结局。

方法和结果：BIOSTAT-CHF研究为心衰患者提高ACE抑制剂/ARBs和/或β-受体阻断剂的剂量专门设计，纳入11个欧洲国家69个中心的2516名心衰患者。剂量增加期间死亡患者（n=151）和LVEF＞40%（n=242）的患者被排除。中位随访期是21个月。在研究的2100名HFrEF患者（76%为男性；平均年龄68±12）中， 22%达到推荐的ACE抑制剂/ARB的治疗剂量，12%达到推荐的β-受体阻断剂治疗剂量。欧洲国家之间存在明显差异。小于推荐ACE抑制剂/ARB治疗剂量50%与死亡和/或心衰住院风险增加相关。达到50～99%推荐的ACE抑制剂/ARB和/或β-受体阻断剂治疗剂量的患者与达到≥100%的患者具有相似的死亡和/或心衰住院风险。由于症状、副作用和非心脏器官功能障碍而未达到推荐剂量的患者死亡率最高（ACE抑制剂/ARB：HR 1.72；95%CI 1.43～2.01；β-受体阻断剂：HR 1.70；95%CI 1.36～2.05）。

结论：同剂量达到≥100%的患者相比，小于50%ACE抑制剂/ARB和/或β-受体阻断剂推荐剂量的HFrEF患者似乎具有较大的死亡和/或心衰住院风险。

原始出处：

Ouwerkerk W, Voors AA, Anker SD,et al.Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure: a prospective European study.Eur Heart J. 2017 Mar 11. doi: 10.1093/eurheartj/ehx026. [Epub ahead of print]

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    2018-05-01 shanyongle

    #ACE#

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    2018-06-01 12498ca5m83暂无昵称

    #阻断剂#

    0

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    2017-12-04 41514497@qq.com

    #阻断#

    0

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createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Fri Jun 01 19:08:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710091, encodeId=e6fe1e100917c, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Mon Dec 04 21:08:00 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356450, encodeId=5a57135645003, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373355, encodeId=862913e33551d, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449235, encodeId=9fba1449235a6, content=<a href='/topic/show?id=2ff746814f0' target=_blank style='color:#2F92EE;'>#射血分数降低#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46814, encryptionId=2ff746814f0, topicName=射血分数降低)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50105466425, createdName=lmm399, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493343, encodeId=17de149334362, content=<a href='/topic/show?id=ff1a4681ee0' target=_blank style='color:#2F92EE;'>#射血分数降低的心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46817, encryptionId=ff1a4681ee0, topicName=射血分数降低的心衰)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74979029791, createdName=fusion, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562648, encodeId=65821562648aa, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229629, encodeId=6ff5229629d5, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Thu Aug 03 17:06:28 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-05 zhaojie88

    #ART#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1655778, encodeId=a53e1655e78a7, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Tue May 01 23:08:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816429, encodeId=8e8418164292f, content=<a href='/topic/show?id=08049e6803b' target=_blank style='color:#2F92EE;'>#阻断剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97680, encryptionId=08049e6803b, topicName=阻断剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Fri Jun 01 19:08:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710091, encodeId=e6fe1e100917c, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Mon Dec 04 21:08:00 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356450, encodeId=5a57135645003, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373355, encodeId=862913e33551d, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449235, encodeId=9fba1449235a6, content=<a href='/topic/show?id=2ff746814f0' target=_blank style='color:#2F92EE;'>#射血分数降低#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46814, encryptionId=2ff746814f0, topicName=射血分数降低)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50105466425, createdName=lmm399, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493343, encodeId=17de149334362, content=<a href='/topic/show?id=ff1a4681ee0' target=_blank style='color:#2F92EE;'>#射血分数降低的心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46817, encryptionId=ff1a4681ee0, topicName=射血分数降低的心衰)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74979029791, createdName=fusion, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562648, encodeId=65821562648aa, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229629, encodeId=6ff5229629d5, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Thu Aug 03 17:06:28 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-05 yuanming7

    #心衰患者#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1655778, encodeId=a53e1655e78a7, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Tue May 01 23:08:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816429, encodeId=8e8418164292f, content=<a href='/topic/show?id=08049e6803b' target=_blank style='color:#2F92EE;'>#阻断剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97680, encryptionId=08049e6803b, topicName=阻断剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Fri Jun 01 19:08:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710091, encodeId=e6fe1e100917c, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Mon Dec 04 21:08:00 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356450, encodeId=5a57135645003, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373355, encodeId=862913e33551d, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449235, encodeId=9fba1449235a6, content=<a href='/topic/show?id=2ff746814f0' target=_blank style='color:#2F92EE;'>#射血分数降低#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46814, encryptionId=2ff746814f0, topicName=射血分数降低)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50105466425, createdName=lmm399, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493343, encodeId=17de149334362, content=<a href='/topic/show?id=ff1a4681ee0' target=_blank style='color:#2F92EE;'>#射血分数降低的心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46817, encryptionId=ff1a4681ee0, topicName=射血分数降低的心衰)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74979029791, createdName=fusion, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562648, encodeId=65821562648aa, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229629, encodeId=6ff5229629d5, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Thu Aug 03 17:06:28 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-05 lmm399

    #射血分数降低#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1655778, encodeId=a53e1655e78a7, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Tue May 01 23:08:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816429, encodeId=8e8418164292f, content=<a href='/topic/show?id=08049e6803b' target=_blank style='color:#2F92EE;'>#阻断剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97680, encryptionId=08049e6803b, topicName=阻断剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Fri Jun 01 19:08:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710091, encodeId=e6fe1e100917c, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Mon Dec 04 21:08:00 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356450, encodeId=5a57135645003, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, 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objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46814, encryptionId=2ff746814f0, topicName=射血分数降低)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50105466425, createdName=lmm399, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493343, encodeId=17de149334362, content=<a href='/topic/show?id=ff1a4681ee0' target=_blank style='color:#2F92EE;'>#射血分数降低的心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46817, encryptionId=ff1a4681ee0, topicName=射血分数降低的心衰)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74979029791, createdName=fusion, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562648, encodeId=65821562648aa, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229629, encodeId=6ff5229629d5, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Thu Aug 03 17:06:28 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-05 fusion

    #射血分数降低的心衰#

    0

  8. 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createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Fri Jun 01 19:08:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710091, encodeId=e6fe1e100917c, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Mon Dec 04 21:08:00 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356450, encodeId=5a57135645003, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, 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2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-05 slcumt

    #HEART#

    0

  9. 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encodeId=65821562648aa, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Aug 05 07:08:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229629, encodeId=6ff5229629d5, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Thu Aug 03 17:06:28 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-03 137****9095

    henhao

    0