WHO颁布首部高血压防治指南,8条推荐须知!

2021-08-26 MedSci原创 MedSci原创

8月25日,《柳叶刀》重磅发布了由世界卫生组织(WHO)和伦敦帝国理工学院主持撰写的首部全球高血压流行趋势综合分析报告发布,本次报告指出,过去30年中,30-79岁成年人患高血压的人数从 6.5 亿增

825日,《柳叶刀》重磅发布了由世界卫生组织(WHO)和伦敦帝国理工学院主持撰写的首部全球高血压流行趋势综合分析报告发布,本次报告指出,过去30年中,30-79岁成年人患高血压的人数从 6.5 亿增加到 12.8 亿,而这些人中近一半不知道自己患有高血压。

该报告强调,虽然高血压很易诊断,而且较易用低成本药物治疗,但研究表明,在诊断和治疗方面仍存在重大差距。大约5.8亿高血压者未获诊断且没有意识到自己的病情。  

与此同时,WHO颁布首部高血压防治指南,以帮助各国改善高血压管理。该指南是 20 年来首次发布的全球高血压治疗指南,基于最新证据提供了一系列的循证指导,包括起始治疗的血压水平、药物选择、血压监测目标等8大项推荐。

抗高血压药物治疗框架

核心推荐1:开始使用药物治疗的血压阈值

对确诊为高血压且收缩压≥140mmHg或舒张压≥90mmHg的个体开始进行药物降压治疗。(强烈推荐,中至高质量证据等级)

对患有心血管疾病且收缩压为130-139mmHg的个体开始进行药物降压治疗。(强烈推荐,中至高质量证据等级)

对没有心血管疾病但有高心血管风险、糖尿病或慢性肾脏疾病且收缩压为130-139mmHg的个体进行药物降压治疗。(有条件的推荐,中至高质量证据等级 

核心推荐2:实验室检测

在开进行药物治疗时,WHO建议进行实验室检测,以筛查合并症和继发性高血压。筛查合并症和继发性高血压,但前提是检查不会延迟或阻碍开始治疗。(有条件推荐,低质量证据等级 )

核心推荐3:心血管疾病风险评估

在开始进行高血压药物治疗时或之后进行心血管疾病风险评估,但必须在可行的情况下进行,且不会延误治疗。(有条件推荐,低质量证据等级 )

核心推荐4:一线药物使用

对于需要药物治疗的成人高血压患者,WHO建议使用以下三类药物中的任何一类药物作为初始治疗(强烈推荐,高质量证据等级 ):

1. 噻嗪类药物

2. 血管紧张素转换酶抑制剂(ACE/血管紧张素受体阻断剂(ARB)。

3. 长效二氢吡啶类钙通道阻滞剂(CCBs)。

核心推荐5:联合治疗

对于需要药物治疗的成人高血压患者,WHO建议采用联合疗法,最好采用单药组合,以提高依从性和持久性。联合治疗中使用的抗高血压药物应从以下三类药物中选择(有条件推荐,中等质量证据等级 ):

1. 利尿剂(噻嗪类);

2. 血管紧张素转换酶抑制剂(ACEs/血管紧张素受体阻断剂(ARBs);

3. 长效二氢吡啶类钙通道阻断剂(CCBs);

核心推荐6:目标血压

所有无合并症的高血压患者的目标血压治疗目标为<140/90 mmHg。(强烈推荐,中等质量证据等级 )

高血压和已知心血管疾病患者的收缩压治疗目标为<130 mmHg。(强烈推荐,中等质量证据等级 )

高危患者,包括心血管疾病高危人群、糖尿病患者、慢性肾脏病患者,收缩压治疗目标为<130 mmHg。(有条件推荐,中等证据证据等级 )

核心推荐7:病情评估频率

WHO建议在开始使用或更换抗高血压药物后,每月进行一次随访,直到患者达到降压目标。(有条件推荐,低质量证据等级 )

对血压得到控制的患者,每3-6个月进行一次随访。(有条件推荐,低质量证据等级 )

核心推荐8:非医生专业人员治疗的建议

高血压治疗药物可由药剂师和护士等非医疗专业人员提供。只要满足以下条件即可:适当的培训、有处方权、有具体的管理协议和医生的监督。(有条件推荐,低质量证据等级  )

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2022-04-01 恒心

    可以

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-11-26 wangweifang

    学习了!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-11-20 120d521dm50暂无昵称

    清晰

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-09-18 苏苏姜

    学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-09-16 zhaoyujuan226

    学习了!

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-09-13 心内科Dr.li

    谢谢分享

    0

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  9. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-09-02 lliuyingying

    联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1740871, encodeId=f2cf1e408712c, content=<a href='/topic/show?id=81fb102e16d1' target=_blank style='color:#2F92EE;'>#高血压防治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102716, encryptionId=81fb102e16d1, topicName=高血压防治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=877734829258, createdName=ms1948154235210413, createdTime=Fri Jul 29 01:52:29 CST 2022, time=2022-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1207831, encodeId=f47f120e83163, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FB3TvKpvrtujQ2N7qVxKiaiaCaWyEhaVeeYp60ibK2Ydhrtsg2JSUm4mjfN0P0lPJP9VhGtZFFFUKuJNbPOibvDPkQ/132, createdBy=f4fe2307331, createdName=恒心, createdTime=Fri Apr 01 13:18:06 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074115, encodeId=855d10e41150e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dd711364661, createdName=wangweifang, createdTime=Fri Nov 26 10:44:42 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072307, encodeId=b2b210e2307e6, content=清晰, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3d3b2210771, createdName=120d521dm50暂无昵称, createdTime=Sat Nov 20 18:54:29 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052509, encodeId=2e72105250990, content=学习 , beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5da5557703, createdName=苏苏姜, createdTime=Sat Sep 18 10:10:11 CST 2021, time=2021-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052092, encodeId=f2a41052092d0, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78db1571227, createdName=zhaoyujuan226, createdTime=Thu Sep 16 21:27:42 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016987, encodeId=befb101698e3f, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1655577185, createdName=心内科Dr.li, createdTime=Mon Sep 13 10:40:42 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078351, encodeId=d35620e83514a, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Dec 06 13:52:29 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014068, encodeId=f44a10140687c, content=联合用药中,单药组合的意思,就是两个单药一起使用吧?不是说推荐直接使用单片复方制剂吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7abe2042877, createdName=lliuyingying, createdTime=Thu Sep 02 21:08:52 CST 2021, time=2021-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011932, encodeId=9a5010119329f, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96ef5561744, createdName=染尘, createdTime=Fri Aug 27 09:06:20 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-08-27 染尘

    厉害

    0

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