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JAMA：难治性紧迫性尿失禁——A型肉毒杆菌毒素OR骶神经调节？

2016-10-05 MedSci MedSci原创

A型肉毒杆菌毒素骶神经调节难治性紧迫性尿失禁
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关于难治性紧迫性尿失禁女性的治疗缺乏骶神经调节与A型肉毒杆菌毒素治疗对比的研究。本研究旨在对比A型肉毒杆菌毒素与骶神经调节的效果。 采用多中心开放标签随机试验研究设计，2012年2月至2015年1月在美国9个医疗中心进行，涉及381名难治性急迫性尿失禁的女性。分别接受膀胱逼尿肌内注射200 UA型肉毒杆菌毒素（n= 192）或骶神经调节（n=189 ）。 主要研究结果为基线时期至治疗6

关于难治性紧迫性尿失禁女性的治疗缺乏骶神经调节与A型肉毒杆菌毒素治疗对比的研究。本研究旨在对比A型肉毒杆菌毒素与骶神经调节的效果。

采用多中心开放标签随机试验研究设计，2012年2月至2015年1月在美国9个医疗中心进行，涉及381名难治性急迫性尿失禁的女性。分别接受膀胱逼尿肌内注射200 UA型肉毒杆菌毒素（n= 192）或骶神经调节（n=189 ）。

主要研究结果为基线时期至治疗6个月患者每日急迫性尿失禁发生次数的变化。次要终点包括膀胱过度活动症问卷简表（SF）的得分变化，膀胱过度活动症满意度问卷，以及不良事件的发生。

研究共纳入364名女性（平均[SD]年龄，63[11.6]岁），A型肉毒杆菌毒素组（190名）女性治疗后6个月内每天紧迫性尿失禁发作的次数较骶神经电刺激组（174名）明显降低（-3.9 vs−3.3次/天；平均差，0.63；95% CI，0.13-1.14；P = 0.01）。


与骶神经调节治疗相比，A型肉毒杆菌毒素组参与者膀胱过度活动症症状问卷SF的改善程度较大（−46.7 vs−38.6；平均差，8.1；95% CI，3-13.3；P = 0.002）；治疗满意度的改善也较大（67.7 vs 59.8；平均差，7.8；95% CI，1.6-14.1；P =0.01）和治疗认可度较大（78.1 vs 67.6；平均差；10.4，95% CI，4.3-16.5；P＜0.001）。

在舒适度（67.6 vs 70.2；平均差，−2.5；95% CI，−8.1~3；P =0.36），不良反应（88.4 vs 85.1；平均差，3.3；95% CI，−1.9~8.5；P =0.22），与治疗偏好（92% VS 89%；风险差异，−3%；95% CI，−16%~10%；P = 0.49）上两组并无明显差异。

A型肉毒杆菌毒素组尿路感染的发生率较骶神经调节组高（35% vs 11%；风险差异，−23%；95% CI，−33%~13%；P＜ 0.001）。A型肉毒杆菌毒素治疗第1个月和第6个月需要自我导尿的患者比例分别为8%和2%。神经调节装置修复和移除的发生率为3%。

总而言之，难治性紧迫性尿失禁的女性中，与骶神经调节治疗相比，A型肉毒杆菌毒素治疗患者每日紧迫性尿失禁发作的次数较少，虽然具有统计学意义但是临床意义并不确定。此外，A型肉毒杆菌毒素治疗的泌尿道感染风险较高，且需要暂时自我导尿。

原始出处：

Cindy L. Amundsen, et al., OnabotulinumtoxinA vs Sacral Neuromodulation on Refractory Urgency Urinary Incontinence in WomenA Randomized Clinical Trial. JAMA. 2016;316(13):1366-1374. doi:10.1001/jama.2016.14617.
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    2017-07-18 jxrzshh

    #A型肉毒杆菌毒素#

    0

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    2017-05-25 jiangfeng5067

    #紧迫性尿失禁#

    0

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    2016-10-07 liubm559

    #肉毒杆菌#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1773128, encodeId=205a1e7312884, content=<a href='/topic/show?id=914c31069d' target=_blank style='color:#2F92EE;'>#A型肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3106, encryptionId=914c31069d, topicName=A型肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=399738493062, createdName=jxrzshh, createdTime=Tue Jul 18 19:07:00 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1804411, encodeId=531c180441116, content=<a href='/topic/show?id=8f4ee7044a1' target=_blank style='color:#2F92EE;'>#紧迫性尿失禁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77044, encryptionId=8f4ee7044a1, topicName=紧迫性尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, 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topicList=[TopicDto(id=47407, encryptionId=0c3c4e407ec, topicName=尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=872f168, createdName=gracezdd, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528329, encodeId=7944152832954, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540543, encodeId=a02515405433f, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141301, encodeId=e56d141301bd, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Oct 06 20:45:32 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141122, encodeId=6fee14112280, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Oct 06 16:55:43 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140932, encodeId=86c414093268, content=可以一试！, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:23 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140931, encodeId=d5561409318c, content=A型肉毒杆菌毒素治疗的泌尿道感染风险较高！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:01 CST 2016, time=2016-10-06, status=1, ipAttribution=)]
    2016-10-07 gracezdd

    #尿失禁#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1773128, encodeId=205a1e7312884, content=<a href='/topic/show?id=914c31069d' target=_blank style='color:#2F92EE;'>#A型肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3106, encryptionId=914c31069d, topicName=A型肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=399738493062, createdName=jxrzshh, createdTime=Tue Jul 18 19:07:00 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1804411, encodeId=531c180441116, content=<a href='/topic/show?id=8f4ee7044a1' target=_blank style='color:#2F92EE;'>#紧迫性尿失禁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77044, encryptionId=8f4ee7044a1, topicName=紧迫性尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, 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topicList=[TopicDto(id=47407, encryptionId=0c3c4e407ec, topicName=尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=872f168, createdName=gracezdd, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528329, encodeId=7944152832954, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540543, encodeId=a02515405433f, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141301, encodeId=e56d141301bd, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Oct 06 20:45:32 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141122, encodeId=6fee14112280, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Oct 06 16:55:43 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140932, encodeId=86c414093268, content=可以一试！, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:23 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140931, encodeId=d5561409318c, content=A型肉毒杆菌毒素治疗的泌尿道感染风险较高！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:01 CST 2016, time=2016-10-06, status=1, ipAttribution=)]
    2016-10-07 freve

    #难治性#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1773128, encodeId=205a1e7312884, content=<a href='/topic/show?id=914c31069d' target=_blank style='color:#2F92EE;'>#A型肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3106, encryptionId=914c31069d, topicName=A型肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=399738493062, createdName=jxrzshh, createdTime=Tue Jul 18 19:07:00 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1804411, encodeId=531c180441116, content=<a href='/topic/show?id=8f4ee7044a1' target=_blank style='color:#2F92EE;'>#紧迫性尿失禁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77044, encryptionId=8f4ee7044a1, topicName=紧迫性尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Thu May 25 14:07:00 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521341, encodeId=3efa152134122, content=<a href='/topic/show?id=34f38085491' target=_blank style='color:#2F92EE;'>#肉毒杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80854, encryptionId=34f38085491, topicName=肉毒杆菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60f411331131, createdName=liubm559, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281655, encodeId=c8e312816550b, content=<a href='/topic/show?id=0c3c4e407ec' target=_blank style='color:#2F92EE;'>#尿失禁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47407, encryptionId=0c3c4e407ec, topicName=尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=872f168, createdName=gracezdd, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528329, encodeId=7944152832954, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540543, encodeId=a02515405433f, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141301, encodeId=e56d141301bd, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Oct 06 20:45:32 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141122, encodeId=6fee14112280, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Oct 06 16:55:43 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140932, encodeId=86c414093268, content=可以一试！, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:23 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140931, encodeId=d5561409318c, content=A型肉毒杆菌毒素治疗的泌尿道感染风险较高！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:01 CST 2016, time=2016-10-06, status=1, ipAttribution=)]
    2016-10-07 wsusan1970

    #肉毒杆菌毒素#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1773128, encodeId=205a1e7312884, content=<a href='/topic/show?id=914c31069d' target=_blank style='color:#2F92EE;'>#A型肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3106, encryptionId=914c31069d, topicName=A型肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=399738493062, createdName=jxrzshh, createdTime=Tue Jul 18 19:07:00 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1804411, encodeId=531c180441116, content=<a href='/topic/show?id=8f4ee7044a1' target=_blank style='color:#2F92EE;'>#紧迫性尿失禁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77044, encryptionId=8f4ee7044a1, topicName=紧迫性尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Thu May 25 14:07:00 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521341, encodeId=3efa152134122, content=<a href='/topic/show?id=34f38085491' target=_blank style='color:#2F92EE;'>#肉毒杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80854, encryptionId=34f38085491, topicName=肉毒杆菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60f411331131, createdName=liubm559, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281655, encodeId=c8e312816550b, content=<a href='/topic/show?id=0c3c4e407ec' target=_blank style='color:#2F92EE;'>#尿失禁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47407, encryptionId=0c3c4e407ec, topicName=尿失禁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=872f168, createdName=gracezdd, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528329, encodeId=7944152832954, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540543, encodeId=a02515405433f, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Fri Oct 07 14:07:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141301, encodeId=e56d141301bd, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Oct 06 20:45:32 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141122, encodeId=6fee14112280, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Oct 06 16:55:43 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140932, encodeId=86c414093268, content=可以一试！, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:23 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140931, encodeId=d5561409318c, content=A型肉毒杆菌毒素治疗的泌尿道感染风险较高！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:01 CST 2016, time=2016-10-06, status=1, ipAttribution=)]
    2016-10-06 忠诚向上

    好好学习

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Oct 06 16:55:43 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140932, encodeId=86c414093268, content=可以一试！, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:23 CST 2016, time=2016-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140931, encodeId=d5561409318c, content=A型肉毒杆菌毒素治疗的泌尿道感染风险较高！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:01 CST 2016, time=2016-10-06, status=1, ipAttribution=)]
    2016-10-06 xiaotaiyang1

    了解一下

    0

  9. 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:01 CST 2016, time=2016-10-06, status=1, ipAttribution=)]
    2016-10-06 drmike

    可以一试！

    0

  10. 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CE4724D2E2574.jpg, createdBy=c2eb1960303, createdName=drmike, createdTime=Thu Oct 06 13:02:01 CST 2016, time=2016-10-06, status=1, ipAttribution=)]
    2016-10-06 drmike

    A型肉毒杆菌毒素治疗的泌尿道感染风险较高！！

    0

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