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NEJM：自膨胀瓣膜TAVR在低危主动脉瓣狭窄患者中的疗效

2019-05-03 xing.T 网络

自膨胀瓣膜TAVR低危主动脉瓣狭窄
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由此可见，对于手术风险较低的严重主动脉瓣狭窄患者，伴有自膨胀超环状生物假体的TAVR在24个月时死亡或致残性卒中的复合终点方面并不劣于手术治疗。

经导管主动脉瓣置换术（TAVR）是严重主动脉瓣狭窄患者手术的替代方法，这些患者手术死亡风险增加；对低风险患者的TAVR疗效知之甚少。

近日，顶级医学期刊NEJM上发表了一篇研究文章，研究人员进行了一项随机非劣效性试验，在患有严重主动脉瓣狭窄且手术风险较低的患者中将具有自膨胀超环状生物假体的TAVR与手术主动脉瓣置换进行比较。当850名患者进行为期12个月的随访时，研究人员使用贝叶斯方法分析了该研究的主要终点数据，即24个月时死亡或致残性卒中的复合事件。

在接受随机化的1468名患者中，1403例患者进行了TAVR或外科手术。患者的平均年龄为74岁。TAVR组的24个月主要终点估计发生率为5.3％，手术组为6.7％（差异为-1.4%; 95％贝叶斯可信区间为-4.9至2.1;非劣效性后验概率>0.999）。在30天时，与手术相比，接受过TAVR治疗的患者卒中致残率（0.5％ vs. 1.7％）、出血并发症（2.4％ vs. 7.5％）、急性肾损伤（0.9％ vs. 2.8％）和心房颤动（7.7％ vs. 35.4％）、中度或重度主动脉瓣关闭不全（3.5％ vs. 0.5％）和起搏器植入（17.4％ vs. 6.1％）的发生率较高。在12个月时，TAVR组患者的主动脉瓣压力梯度低于手术组（8.6mmHg vs. 11.2mmHg），并且具有较大的有效瓣膜面积（2.3cm2 vs. 2.0cm2）。

由此可见，对于手术风险较低的严重主动脉瓣狭窄患者，伴有自膨胀超环状生物假体的TAVR在24个月时死亡或致残性卒中的复合终点方面并不劣于手术治疗。

原始出处：

Jeffrey J. Popma,et al.Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients.NEJM.2019.https://www.nejm.org/doi/full/10.1056/NEJMoa1816885

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    2021-03-23 病毒猎手

    #TAVR#

    0

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    2019-06-08 sunmin0219

    #自膨胀瓣膜#

    0

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    2019-11-04 wangtianj2007@

    #AVR#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=950502, encodeId=79d39505023d, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:59:25 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810767, encodeId=04cb1810e67f9, content=<a href='/topic/show?id=189a8631211' target=_blank style='color:#2F92EE;'>#自膨胀瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86312, encryptionId=189a8631211, topicName=自膨胀瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5462342, createdName=sunmin0219, createdTime=Sat Jun 08 21:50:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086366, encodeId=2068208636613, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Mon Nov 04 10:50:00 CST 2019, time=2019-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332645, encodeId=0915133264555, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415513, encodeId=b9cd14155133b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583620, encodeId=ef101583620d2, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365702, encodeId=95a6365e0215, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat May 04 09:46:01 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032149, encodeId=7b9310321495a, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034812, encodeId=e4bc1034812bc, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=)]
    2019-05-05 hittouch

    #主动脉瓣#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=950502, encodeId=79d39505023d, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:59:25 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810767, encodeId=04cb1810e67f9, content=<a href='/topic/show?id=189a8631211' target=_blank style='color:#2F92EE;'>#自膨胀瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86312, encryptionId=189a8631211, topicName=自膨胀瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5462342, createdName=sunmin0219, createdTime=Sat Jun 08 21:50:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086366, encodeId=2068208636613, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Mon Nov 04 10:50:00 CST 2019, time=2019-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332645, encodeId=0915133264555, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415513, encodeId=b9cd14155133b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583620, encodeId=ef101583620d2, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365702, encodeId=95a6365e0215, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat May 04 09:46:01 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032149, encodeId=7b9310321495a, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034812, encodeId=e4bc1034812bc, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=)]
    2019-05-05 circumcision

    #主动脉#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=950502, encodeId=79d39505023d, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:59:25 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810767, encodeId=04cb1810e67f9, content=<a href='/topic/show?id=189a8631211' target=_blank style='color:#2F92EE;'>#自膨胀瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86312, encryptionId=189a8631211, topicName=自膨胀瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5462342, createdName=sunmin0219, createdTime=Sat Jun 08 21:50:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086366, encodeId=2068208636613, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Mon Nov 04 10:50:00 CST 2019, time=2019-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332645, encodeId=0915133264555, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415513, encodeId=b9cd14155133b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583620, encodeId=ef101583620d2, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365702, encodeId=95a6365e0215, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat May 04 09:46:01 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032149, encodeId=7b9310321495a, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034812, encodeId=e4bc1034812bc, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=)]
    2019-05-05 12498e5fm17(暂无昵称)

    #瓣膜#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=950502, encodeId=79d39505023d, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:59:25 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810767, encodeId=04cb1810e67f9, content=<a href='/topic/show?id=189a8631211' target=_blank style='color:#2F92EE;'>#自膨胀瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86312, encryptionId=189a8631211, topicName=自膨胀瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5462342, createdName=sunmin0219, createdTime=Sat Jun 08 21:50:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086366, encodeId=2068208636613, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Mon Nov 04 10:50:00 CST 2019, time=2019-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332645, encodeId=0915133264555, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415513, encodeId=b9cd14155133b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583620, encodeId=ef101583620d2, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365702, encodeId=95a6365e0215, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat May 04 09:46:01 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032149, encodeId=7b9310321495a, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034812, encodeId=e4bc1034812bc, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=)]
    2019-05-04 1e17414fm02(暂无匿称)

    学习

    0

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    2019-05-04 内科新手

    谢谢梅斯提供这么好的信息，学到很多

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=950502, encodeId=79d39505023d, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:59:25 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810767, encodeId=04cb1810e67f9, content=<a href='/topic/show?id=189a8631211' target=_blank style='color:#2F92EE;'>#自膨胀瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86312, encryptionId=189a8631211, topicName=自膨胀瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5462342, createdName=sunmin0219, createdTime=Sat Jun 08 21:50:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086366, encodeId=2068208636613, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Mon Nov 04 10:50:00 CST 2019, time=2019-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332645, encodeId=0915133264555, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415513, encodeId=b9cd14155133b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583620, encodeId=ef101583620d2, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun May 05 14:50:00 CST 2019, time=2019-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365702, encodeId=95a6365e0215, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat May 04 09:46:01 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032149, encodeId=7b9310321495a, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034812, encodeId=e4bc1034812bc, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 04 02:50:00 CST 2019, time=2019-05-04, status=1, ipAttribution=)]
    2019-05-04 旺医

    顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息

    0