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Heart：尿液分析有助于降压治疗的临床决策

2014-04-04 佚名 不详

尿液分析降压
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一项小型研究显示，通过一种简单的尿液分析就可以帮助医生评价患者对降压药的无反应是由于药物治疗抵抗还是不依从。该研究在线发表于Heart杂志。 研究者发现，在高血压诊所中评估的患者有25%至少是部分不依从降压治疗。英国莱斯特大学的Maciej Tomaszewski博士指出，通过尿液化验可以发现40种常用的降压药物。不依从与较高的血压水平相关，完全不依从的治疗的患者在尿液中不能检出处方的降压药

一项小型研究显示，通过一种简单的尿液分析就可以帮助医生评价患者对降压药的无反应是由于药物治疗抵抗还是不依从。该研究在线发表于Heart杂志。

研究者发现，在高血压诊所中评估的患者有25%至少是部分不依从降压治疗。英国莱斯特大学的Maciej Tomaszewski博士指出，通过尿液化验可以发现40种常用的降压药物。不依从与较高的血压水平相关，完全不依从的治疗的患者在尿液中不能检出处方的降压药物成分。




研究者写道，基于高效液相色谱串联质谱法的尿液分析是一个简单的非侵入性诊断测试，可以更好地对患者进行分层，以帮助决定是否进行治疗升级和给予不可逆的手术，如去肾交感神经术。

但成本似乎是一个问题。尽管每个尿液测试成本只有大约30英镑，但分析仪却耗资不菲，大约是15万英镑。

在未来的大型多中心研究中，需要提供估计的直接生化治疗不依从，以及在这种情况下难治性高血压管理的总体支出和筛选方法的成本效益评估。

研究简介

药物依从性影响多种慢性疾病的控制，包括高血压。依从性差可导致至少10%-20%的高血压患者被认定为对治疗抵抗。但没有一种可靠地评价方法，因此关于依从性差的百分率报道各不相同（3%-65%）。

Tomaszewski等对专业高血压诊所评估认定的不依从患者给予了高效液相色谱串联质谱法尿液分析。共包括208例，平均年龄57岁，其中125例来自初级保健中心推荐的新患者，66例为高血压控制不佳的随访患者，17例为考虑进行去肾交感神经术的患者。

尿液检测显示，10.1%的患者没有服用药物（完全不依从），14.9的患者部分服药（部分不依从）。高血压控制不佳的随访患者完全和部分不依从的比例最高，为37.9%.考虑进行去肾交感神经术的患者不依从的比例也惊人的高，为23.5%.

研究人员指出，大多数患者都要在二、三级医疗中心定期接受许多额外的检查以寻找患者对治疗无反应的原因。我们的研究表明，如果将尿液分析用于上述患者的常规筛查，将能避免20%的患者进行不必要的额外检查或治疗。

剑桥大学Morris Brown博士说，将不依从率作为拟行去肾交感神经术患者的评估手段对RDN来说是一个“冲击”。当一项干预无效而且不可逆转时，后果是严重的。现在RDN治疗似乎发生了这种不幸。Brown博士这番话直指刚刚宣布失败的SYMPLICITY HTN-3试验。有了这项检查，我们不用再猜测哪些患者是难治性高血压患者，我们可以知道，Brown写道。

Tomaszewski等承认该研究存在局限性，包括：大约1/4的患者以及小部分拟行去肾交感神经术的患者缺乏24h血压数据，使用单一的尿液分析不能去除混杂因素导致的偏倚，缺乏可与尿液分析测试结果进行比较的间接信息。

原始出处：

Todd Neale, Zalman S. Agus. Urine Test Can Uncover BP Med Adherence. Medpage today. Apr 2, 2014.

Tomaszewski M1, White C, Patel P, Masca N, Damani R, Hepworth J, Samani NJ, Gupta P, Madira W, Stanley A, Williams B.High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis.Heart. 2014 Apr 2. doi: 10.1136/heartjnl-2013-305063.

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    2014-10-12 wwzzly

    #临床决策#

    0

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    2014-04-06 经常头晕

    #降压#

    0

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    2014-04-06 zhaojie88

    #ART#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1723190, encodeId=3beb1e23190d1, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=810a33379458, createdName=wwzzly, createdTime=Sun Oct 12 16:40:00 CST 2014, time=2014-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291816, encodeId=1888129181661, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355843, encodeId=f8241355843ee, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360840, encodeId=6fb91360840fc, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449300, encodeId=7a4e1449300e6, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541758, encodeId=8a1c1541e581b, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562222, encodeId=3dce156222222, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593380, encodeId=8166159338019, content=<a href='/topic/show?id=fc8e4e44406' target=_blank style='color:#2F92EE;'>#尿液分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47444, encryptionId=fc8e4e44406, topicName=尿液分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7cc418139081, createdName=chenshujs, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=)]
    2014-04-06 xugumin

    #降压治疗#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1723190, encodeId=3beb1e23190d1, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=810a33379458, createdName=wwzzly, createdTime=Sun Oct 12 16:40:00 CST 2014, time=2014-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291816, encodeId=1888129181661, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355843, encodeId=f8241355843ee, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360840, encodeId=6fb91360840fc, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449300, encodeId=7a4e1449300e6, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541758, encodeId=8a1c1541e581b, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562222, encodeId=3dce156222222, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593380, encodeId=8166159338019, content=<a href='/topic/show?id=fc8e4e44406' target=_blank style='color:#2F92EE;'>#尿液分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47444, encryptionId=fc8e4e44406, topicName=尿液分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7cc418139081, createdName=chenshujs, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=)]
    2014-04-06 zhaohui6733

    #尿液#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1723190, encodeId=3beb1e23190d1, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=810a33379458, createdName=wwzzly, createdTime=Sun Oct 12 16:40:00 CST 2014, time=2014-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291816, encodeId=1888129181661, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355843, encodeId=f8241355843ee, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360840, encodeId=6fb91360840fc, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449300, encodeId=7a4e1449300e6, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541758, encodeId=8a1c1541e581b, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562222, encodeId=3dce156222222, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593380, encodeId=8166159338019, content=<a href='/topic/show?id=fc8e4e44406' target=_blank style='color:#2F92EE;'>#尿液分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47444, encryptionId=fc8e4e44406, topicName=尿液分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7cc418139081, createdName=chenshujs, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=)]
    2014-04-06 ms2999106592497887

    #决策#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1723190, encodeId=3beb1e23190d1, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=810a33379458, createdName=wwzzly, createdTime=Sun Oct 12 16:40:00 CST 2014, time=2014-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291816, encodeId=1888129181661, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355843, encodeId=f8241355843ee, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360840, encodeId=6fb91360840fc, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449300, encodeId=7a4e1449300e6, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541758, encodeId=8a1c1541e581b, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562222, encodeId=3dce156222222, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593380, encodeId=8166159338019, content=<a href='/topic/show?id=fc8e4e44406' target=_blank style='color:#2F92EE;'>#尿液分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47444, encryptionId=fc8e4e44406, topicName=尿液分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7cc418139081, createdName=chenshujs, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=)]
    2014-04-06 爆笑小医

    #HEART#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1723190, encodeId=3beb1e23190d1, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=810a33379458, createdName=wwzzly, createdTime=Sun Oct 12 16:40:00 CST 2014, time=2014-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291816, encodeId=1888129181661, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355843, encodeId=f8241355843ee, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360840, encodeId=6fb91360840fc, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449300, encodeId=7a4e1449300e6, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541758, encodeId=8a1c1541e581b, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562222, encodeId=3dce156222222, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593380, encodeId=8166159338019, content=<a href='/topic/show?id=fc8e4e44406' target=_blank style='color:#2F92EE;'>#尿液分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47444, encryptionId=fc8e4e44406, topicName=尿液分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7cc418139081, createdName=chenshujs, createdTime=Sun Apr 06 01:40:00 CST 2014, time=2014-04-06, status=1, ipAttribution=)]
    2014-04-06 chenshujs

    #尿液分析#

    0