血管活性药物使用要点,这篇总结不可不看!

2022-05-15 心血管时空 心血管时空

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血管收缩药物

1. 多巴胺(Dopamine,Dopa)
  • 最常用的血管活性药
  • 以剂量依赖方式兴奋多巴胺能受体,β1、 α1受体,促进内源性去甲肾上腺素释放
图片
 
低剂量:(1~2µg/kg·min)(多巴胺受体)使肾、冠脉、脑、肠系膜血管扩张,肾血流量及肾小球滤过率增加,尿量及钠排泄量增加血压
 
中剂量 :(2~10µg/kg·min)(β1、α1受体)心率升高、心肌收缩力升高、心排量升高、体循环阻力增加不明显
 
大剂量:10µg/kg·min以上(α1受体)使全身动、静脉血管收缩。>20µg/kg·min 时作用类似去甲肾上腺素
 
适合于尿少、血压低、心排量低的患者,但需排除血容量不足。
  • 剂量>5µg/kg·min时,对肺高压和体循环阻力大的患者要慎重,应采取能改善组织灌注的最低剂量
  • 如多巴胺剂量达到20µg/kg·min,患者血压仍难以维持,应加用去去甲肾上腺素,因为肾上腺素不能增强大剂量多巴胺的缩血管效应 
  • 休克患者多巴胺初始剂量为5~10µg/kg·min,逐渐增至血压、尿量及其他组织灌注指标改善。剂量过大(20~40µg/kg·min)可导致心率过快内源性去甲肾上腺素储备耗竭,使患者对缩血管药物丧失反应。
多巴胺应用中注意
 
1.采用有效的最低剂量,最大剂量<30µg/kg·min
 
2.用注射泵或输液泵给药,以确保剂量的精确控制和输入速率均一
 
3.有指征的患者应尽早使用 
 
4.停药前逐渐减量,以防低血压,同时要使容量负荷达到优化
 
5.加快心率,增加心肌氧耗(某些情况下可导致心肌缺血)和乳酸产生增加,增加肺循环阻力(有时可使心排量下降)
 
6.大剂量可引起恶心、呕吐,如漏出血管可引起皮肤皮下组织坏死 (及时发现可局部应用普鲁卡因或酚妥拉明)
 
7.不可与碱性药物混用(如速尿)
 
2. 肾上腺素 (Epinephrine,Epi)
 
强效的正性肌力药物。可加快心率,提高每搏量,并增加心肌血流量,也有明显的致心律失常作用,作用于小动脉及毛细血管具有极强效的血管收缩作用。
 
对肾脏与皮肤血管床的血管收缩作用特别显著,对冠状动脉和骨骼肌则呈现血管舒张作用。低剂量时,血管扩张作用大于血管收缩作用,可出现血压下降。
 
心肺复苏和抢救过敏性休克的首选药,低心排综合征大剂量多巴胺无效时的二线药物。
 
性质不稳定,接触空气或受日光照射,极易被氧化变质,在中性尤其碱性溶液中迅速氧化变色而失效。
 
3. 去甲肾上腺素(Norepinephrine,NE)
  • 是从肾上腺素中去掉N-甲基的物质。强力α受体兴奋剂,,收缩血管 (动脉和静脉),β1兴奋剂(促进心肌收缩)
  • 有可能引起心肌缺血(增加心肌氧耗、刺激冠脉α受体),冠脉供血不足者慎用。
  • 低血容量休克禁用或慎用,除外在紧急情况下用以在补足容量前维持冠脉和脑的灌注。 
  • 4~8µg/min  监测血压和尿量,调整用药速度。极量25µg/min。
  • 预防肾血管收缩致急性肾功能衰竭或加剧心功能衰竭,可同时静滴小剂量多巴胺(1~2µg/min)或者酚妥拉明。
使用时注意
  • 为防止注射局部组织坏死,可用中心静脉导管方法或选择大静脉给药
  • 注意血容量补充(根据中心静脉压)
  • 小剂量和低浓度给药,不宜长时间持续用药,以免血管剧烈收缩,加剧微循环障碍
肾上腺素与去甲肾上腺素的比较
  • 血液中的肾上腺素和去甲肾上腺素主要由肾上腺髓质所分泌,两者对心和血管的作用,既有共性,又有特殊性,这是因为它们与心肌和血管平滑肌细胞膜上不同的肾上腺素能受体,结合能力不同所致。 
  • 肾上腺素是α、β受体激动剂,作用于心肌、传导系统和窦房结的β1和β2受体。临床常作为强心急救药。 
  • 去甲肾上腺素是α受体激动药,对心脏β1受体作用较弱,对β2受体几乎无作用。临床常作为升压药应用。
4. 异丙肾上腺素(Isoproterenol)
  • 异丙肾上腺素为纯β-肾上腺素能受体激动剂,主要激动β受体,对β1和β2受体选择性很低,对α受体几乎无作用。它可增强心肌收缩力和增加心肌氧耗,引起 心率增快。
  • 作为一线药物用于治疗严重的心动过缓、心脏阻滞和其他传导异常以及心脏移植后去神经支配心脏的患者。其β2-受体兴奋作用及刺激心房肽分泌作用能引起血管显著扩张。
  • 异丙肾上腺素可诱发心律失常。增加心肌氧耗,降低心肌灌注压,可引起或加重心肌缺血,慎用于冠脉供血不足者。
  • 剂量通常从0.5~1.0µg/min开始,逐渐增加以取得理想的药理效应。
5. 间羟胺(Metaraminat) 
 
间羟胺,阿拉明
  • 直接兴奋α-受体,主要通过促进神经突触释放储存的儿茶酚胺而间接发挥作用,使血管平滑肌收缩,具有较强升血压作用,为外周升压药。其作用与去甲肾上腺素相似,但较弱。
间羟胺与去甲肾上腺素比较
 
1.升压作用弱而持久
 
2.对心律影响较小,交少引起心律失常
 
3.对肾脏血管的收缩作用较弱,但仍能减少肾脏血流量
 
4.可肌肉注射
 
血管扩张剂的临床应用
 
1. 硝普钠(Sodium Nitroprusside)
 
药理作用:由于它迅速代谢成氰化物和一氧化氮,故很快发挥作用,为一种强力短效血管扩张剂,直接使小动脉及静脉平滑肌松弛,降低周围血管阻力及使静脉贮血
 
临床应用:各种高血压危象或急症急性左心衰
 
常规剂量:起始滴速一般为0.3μg/kg·min,根据血流动力学反应缓慢向上调节滴速。常用剂量为0.1~5μg/kg·min
 
副作用:长期大量使用可导致重要脏器和组织血流减少,加重微循环障碍,可致急性肾功能衰竭;低血压;氰化物中毒
 
使用时注意
  • 易致低血压应在血流动力学监测下使用
  • 用药时间延长(3天以上)或剂量过大,可出现氰化物中毒或甲状腺功能减退
  • 在避光条件下应用,4-6h更换
2. 酚妥拉明(苄胺唑啉、立其丁)
 
为α1、α2受体阻断剂,使动脉扩张,体循环和肺循环阻力降低, 心排出量增加,改善心功能及组织灌注。增加心输出量的作用与硝 普钠相似,降低前负荷(心室舒张末期容量)的作用比硝普钠弱。
 
最早应用于治疗心力衰竭、抗休克、改善微循环。与去甲肾上腺素合用有协同阻断去甲肾上腺素的α受体的兴奋作用。
 
3. 硝酸甘油
 
药理作用:直接扩张周围血管,以扩张静脉为主;主要减轻心脏前负荷。由于对心外膜冠状血管相对选择性的扩血管作用,除了降低心室充盈压、室壁应力和氧耗外,尚能通过改善缺血性心肌病患者的冠脉血流,而改善心室收缩和舒张功能。
 
临床应用:左心衰竭(尤其是急性心梗所致);急性心梗伴严重的心绞痛
 
常规剂量:开始剂量5~10μg/min(或0.5-1.0μg/kg/min),隔5min可增加剂量,维持速度3-5μg/kg/min,一般不超过10μg/kg/min,总量不超过0.5mg/kg/h;有效后,应缓慢减量,不应骤停,以防心绞痛复发
 
副作用:有头痛、头晕、也可出现体位性低血压;青光眼,冠状动脉闭塞及血栓形成、脑出血、颅内压增高者忌用。 
 
使用时注意 
  • 防止血压极度下降,加强对血压的监测
  • 作用短暂,停药后15~30分钟即可失效,故应持续静脉滴注
  • 用药后病人可以迅速耐受,只适用于急性期用药
正性肌力药物
 
1. 多巴酚丁胺(Dobutamine)
 
多巴酚丁胺为多巴胺同系物,为一选择性心脏β1-受体兴奋剂。 
 
对心肌产生正性肌力作用,主要作用于β1受体,对β2及α受体作用相对较小。 
 
能直接激动心脏β1受体以增强心肌收缩和增加搏出量,使心排血量增加。 
 
可降低外周血管阻力(后负荷减少),但收缩压和脉压一般保持不变,或仅因心排血量增加而有所增加。
 
本品与多巴胺不同,多巴酚丁胺并不间接通过内源性去甲肾上腺素的释放,而是直接作用于心脏。
 
临床上多利用其强心作用。多用于:
  • 充血性心力衰竭,尤适用于慢性代偿性心衰和严重心衰,用药后血流动力学改善,表现为心排量增加,肺动脉压和肺小动脉契嵌压下降,尿量增加。
  • 心脏手术后低排高阻型心功能不全。
  • 急性心梗并低心排量。
  • 感染性休克,细菌毒素、炎性介质等致心肌受损,心功能下降,在血容量补充后血压仍不能维持时。
2. 米力农和氨力农(milrinone and  amrinone)
 
属非甙、非儿茶酚胺类的强心药。也是治疗急性心力衰竭或低心排血量综合征的强心药。兼有正性肌力作用和血管扩张作用。
 
药理作用:选择性抑制心肌磷酸二酯酶而增加心肌细胞内环磷酸腺苷(cAMP),使细胞内Ca2+浓度升高,从而增强心肌收缩力;其血管扩张作用的机制可能是直接作用于血管平滑肌使之松弛,导致SVR下降,这一作用呈剂量依赖性;较高剂量可降低左室充盈压(通过增强等容舒张性)和肺动脉压。
 
适用于对洋地黄、利尿剂、血管扩张剂治疗无效或效果欠佳的各种原因引起的急、慢性顽固性充血性心力衰竭。 
 
3. 洋地黄类(digitalis)
 
根据作用强度快慢和维持时间长短可分为三类:
 
  ①慢效类:洋地黄、洋地黄毒甙等
 
  ②中效类:如地高辛、甲基地高辛等
 
  ③速效类:如西地兰、毒毛旋花子甙K等。
 
急症危重病人常选用速效类强心甙,最常用者为西地兰(cedilanid)。
 
西地兰(cedilanid)
 
为快速强心药,能加强心肌收缩,减慢心率与传导,但作用快而蓄积性小,治疗量与中毒量之间的差距较大于其他洋地黄类强心甙。口服在肠中吸收不完全,服后2小时见效,经3—6日作用消失。
 
临床应用:
 
1.主要用于急、慢性充血性心力衰竭,对风湿性心脏病、高血压、动脉硬化、先心病等引起心衰效果较好。
 
2.对非洋地黄类药物引起的快速房颤、房扑及阵发性室上速有较好疗效。
 
剂量与用法:
  • 首次0.4-0.8mg,2-4小时后再给予0.2-0.4mg,以葡萄糖20ml释放后缓慢静注。
  • 在治疗心衰时剂量宜小,而抗快速性心律失常时用量宜大。
副作用和注意事项:
 
1.洋地黄类治疗安全范围较小,治疗量约为中毒量的2/3,在缺氧、心肌损害、电解质失衡、甲状腺功能减低等情况下易致中毒,其中毒反应表现多样化,涉及各类心律失常和消化系统、神经系统及皮肤症状,一旦发生消化系统症状,有时临床上很难鉴别洋地黄过量中毒抑或用量不足。
 
2.不合理使用引起心动过缓,甚至发生严重缓慢性心律失常。
 
3.急性心肌梗死合并心衰,发病24小时内尽量不用洋地黄,避免扩大梗死面或导致心脏破裂。
 
4.洋地黄类忌用于心脏电复律术、肥厚梗阻型心肌病及缩窄性心包炎等病人,否则易致猝死。
 
抗胆碱类药
  • 阿托品 
  • 山莨菪碱(654-2)
  • 莨菪类药
  • 东莨菪碱
其抗休克的主要药理作用是解除小动脉和微血管的痉挛,改善休 克时的微循环障碍。临床主要用于感染性休克,特别是休克伴有呼吸衰竭者疗效更好。
 
纳洛酮  (Naloxone)
 
特异性阿片受体拮抗剂:阻断心血管上μ、κ受体,从而解除β-内啡肽对血管的抑制作用 (休克时血中的β-内啡肽水平增高,升高的程度与其血压水平呈负相关),故可逆转休克
 
对正常人并无加压作用,仅在休克状态下才呈升压作用。可用于各种类型的休克,更适用于感染性休克,对创伤性休克,可能降低病人的痛阈。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
    2023-02-13 小月习习のID 来自贵州省
  2. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
    2022-05-16 weigq

    学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
    2022-05-16 1355517cm30暂无昵称

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
    2022-05-16 大光

    学习了,谢谢分享

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
    2022-05-16 ms8000000659681751

    感谢

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
    2022-05-15 1209e435m98(暂无昵称)

    学习了,谢分享

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2114382, encodeId=0cc12114382e0, content=<a href='/topic/show?id=2ea4896812a' target=_blank style='color:#2F92EE;'>#血管活性药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89681, encryptionId=2ea4896812a, topicName=血管活性药物)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220103/d71c87cfe1bc4f52b1d0bbb4c7208646/a68fd99db0bd42eabc4fca344768357e.jpg, createdBy=5f626445078, createdName=小月习习のID, createdTime=Mon Feb 13 11:27:29 CST 2023, time=2023-02-13, status=1, ipAttribution=贵州省), GetPortalCommentsPageByObjectIdResponse(id=1971608, encodeId=4ab919e160837, content=<a href='/topic/show?id=797b8e67141' target=_blank style='color:#2F92EE;'>#药物使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87671, encryptionId=797b8e67141, topicName=药物使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Sat Jun 04 17:44:09 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220042, encodeId=e1581220042dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Mon May 16 16:11:48 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219986, encodeId=f97712199867e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77d93729410, createdName=1355517cm30暂无昵称, createdTime=Mon May 16 13:16:03 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219883, encodeId=c1fc1219883e5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJbibsxJPyM36vENWicvqMe2IS4ibZYHPAXpaHlhYTjibOUAV1yk2L9TWnMuUe686pjGzpiaDZdfjmaIhQ/132, createdBy=93121739292, createdName=大光, createdTime=Mon May 16 02:01:09 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219872, encodeId=613812198e231, content=感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44d66467424, createdName=ms8000000659681751, createdTime=Mon May 16 01:07:24 CST 2022, time=2022-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219866, encodeId=d50212198665a, content=学习了,谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun May 15 23:58:11 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219852, encodeId=c4f2121985205, content=重点清楚,方便学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa0b6157897, createdName=ms3000000098940767, createdTime=Sun May 15 22:19:07 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219832, encodeId=46001219832ac, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sun May 15 21:12:38 CST 2022, time=2022-05-15, status=1, ipAttribution=)]
    2022-05-15 ms3000000098940767

    重点清楚,方便学习

    0

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    2022-05-15 医鸣惊人

    认真学习了

    0

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