心血管疾病患者血糖管理的5个维度

2015-11-26 国际糖尿病 国际糖尿病

CVD患者血糖管理5维模式 李焱教授讲到,大量国内外指南和共识对CVD患者的血糖管理策略已作出详细推荐和建议。综观这些指导性文件可见,CVD患者的血糖管理并非简单使用降糖药,而需关注降糖治疗中的5个参数:空腹血糖(FPG)、餐后血糖(PPG)、糖化血红蛋白(HbA1c)、血糖波动和低血糖。因血糖处于动态变化之中,立体式、全方位的血糖管理可最大程度覆盖整个病理过程,延缓CVD发展。1 FPG由于操作

CVD患者血糖管理5维模式 李焱教授讲到,大量国内外指南和共识对CVD患者的血糖管理策略已作出详细推荐和建议。综观这些指导性文件可见,CVD患者的血糖管理并非简单使用降糖药,而需关注降糖治疗中的5个参数:空腹血糖(FPG)、餐后血糖(PPG)、糖化血红蛋白(HbA1c)、血糖波动和低血糖。因血糖处于动态变化之中,立体式、全方位的血糖管理可最大程度覆盖整个病理过程,延缓CVD发展。

1 FPG

由于操作相对简便,FPG是筛查和监测糖尿病的最常用指标。Framingham研究事后分析结果显示,FPG与女性冠心病风险增加相关,但未增加男性冠状动脉粥样硬化性CVD或冠心病的短期风险。

2 PPG

糖尿病发生发展的自然进程中,PPG升高先于FPG。多项研究表明,餐后高血糖比例高是中国CVD患者糖代谢异常的显著特点。San Luigi Gonzaga糖尿病研究14年随访数据证实,PPG是心血管事件及全因死亡的预测指标。DECODA研究发现,与FPG相比,PPG升高与2型糖尿病(T2DM)患者的心血管事件风险增加显著相关。餐后高血糖可加重内皮功能失调,促进动脉粥样硬化的发生及发展。

3 HbA1c

多项荟萃分析表明,HbA1c升高可增加T2DM患者的CVD发生及死亡风险。UKPDS研究发现,严格控制HbA1c并不能为糖尿病患者带来更多心血管获益。强化控制HbA1c是否能带来确切心血管获益尚存争议。而ACCORD、ADVANCE和VADT等研究发现,强化控制HbA1c尽管可降低微血管并发症,但未必能带来大血管获益。2015年发表的《糖代谢异常与动脉粥样硬化性心血管疾病临床诊断和治疗指南》指出,合并CVD的患者一般HbA1c目标应控制在7.0%~8.5%,但要个体化调整。

4 血糖波动

近年来,人们逐渐认识到,血糖波动比血糖持续性增高对血管的危害更大。马长生教授团队的研究发现,平均血糖波动幅度(MAGE)是冠心病的独立危险因素,MAGE≥3.4 mmol/L,CVD风险增加2.6倍。Saisho Y等指出,血糖波动促进CVD发生发展的主要机制是急剧血糖变化激活体内氧化应激反应,最终加速动脉粥样斑块形成。

5 低血糖

Cryer PE曾指出,一次严重的医源性低血糖或由此诱发的心血管事件,可能会抵消一生维持血糖在正常范围所带来的益处。Kosiborod M等的研究发现,急性心肌梗死患者的血糖水平与死亡呈J型相关,血糖控制得过低可增加死亡风险。Lung TW等的研究也表明,严重低血糖显著增加已发生心血管事件的糖尿病患者的死亡风险。

总结 

对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后。阿卡波糖能够有效降低FPG、PPG和HbA1c,减少血糖波动,不引发低血糖,是CVD患者基于5维血糖管理模型的理想口服降糖药选择之一。

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    2017-09-16 Peter_sz

    dpp4抑制剂的低血糖发生率也是呈中性的

    0

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    2015-11-29 1ddd488dm47(暂无匿称)

    那阿卡波糖为CVD患者的首选降糖药了?

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=244624, encodeId=765624462455, content=dpp4抑制剂的低血糖发生率也是呈中性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33b02146058, createdName=Peter_sz, createdTime=Sat Sep 16 11:21:05 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798944, encodeId=51171e9894426, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Fri Jul 22 22:59:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44100, encodeId=1c0644100af, content=那阿卡波糖为CVD患者的首选降糖药了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8861654295, createdName=1ddd488dm47(暂无匿称), createdTime=Sun Nov 29 13:40:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44020, encodeId=459b4402057, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=31221666631, createdName=奔跑3225, createdTime=Sat Nov 28 12:33:00 CST 2015, time=2015-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497936, encodeId=469f149e9364e, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521564, encodeId=1ac7152156441, content=<a href='/topic/show?id=3c4e8985327' target=_blank style='color:#2F92EE;'>#血糖管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89853, encryptionId=3c4e8985327, topicName=血糖管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2da11366066, createdName=zhangying8792, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44000, encodeId=69df4400040, content=嘿嘿好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Nov 27 21:40:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43929, encodeId=227c4392961, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Thu Nov 26 21:06:00 CST 2015, time=2015-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43860, encodeId=2a4b438600b, content=对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后..., beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLB1WyQmmv2iazjCicO1CnvpCXOlCjJ1xJjmOQowmd5bSxCtVMicaZs7icQkxicMQCzTXgk8GEBKxnYuCxw/0, createdBy=ecf81608992, createdName=wxsessiond1c0d06a, createdTime=Thu Nov 26 10:12:00 CST 2015, time=2015-11-26, status=1, ipAttribution=)]
    2015-11-28 奔跑3225

    好!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=244624, encodeId=765624462455, content=dpp4抑制剂的低血糖发生率也是呈中性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33b02146058, createdName=Peter_sz, createdTime=Sat Sep 16 11:21:05 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798944, encodeId=51171e9894426, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Fri Jul 22 22:59:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44100, encodeId=1c0644100af, content=那阿卡波糖为CVD患者的首选降糖药了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8861654295, createdName=1ddd488dm47(暂无匿称), createdTime=Sun Nov 29 13:40:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44020, encodeId=459b4402057, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=31221666631, createdName=奔跑3225, createdTime=Sat Nov 28 12:33:00 CST 2015, time=2015-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497936, encodeId=469f149e9364e, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521564, encodeId=1ac7152156441, content=<a href='/topic/show?id=3c4e8985327' target=_blank style='color:#2F92EE;'>#血糖管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89853, encryptionId=3c4e8985327, topicName=血糖管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2da11366066, createdName=zhangying8792, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44000, encodeId=69df4400040, content=嘿嘿好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Nov 27 21:40:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43929, encodeId=227c4392961, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Thu Nov 26 21:06:00 CST 2015, time=2015-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43860, encodeId=2a4b438600b, content=对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后..., beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLB1WyQmmv2iazjCicO1CnvpCXOlCjJ1xJjmOQowmd5bSxCtVMicaZs7icQkxicMQCzTXgk8GEBKxnYuCxw/0, createdBy=ecf81608992, createdName=wxsessiond1c0d06a, createdTime=Thu Nov 26 10:12:00 CST 2015, time=2015-11-26, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=244624, encodeId=765624462455, content=dpp4抑制剂的低血糖发生率也是呈中性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33b02146058, createdName=Peter_sz, createdTime=Sat Sep 16 11:21:05 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798944, encodeId=51171e9894426, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Fri Jul 22 22:59:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44100, encodeId=1c0644100af, content=那阿卡波糖为CVD患者的首选降糖药了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8861654295, createdName=1ddd488dm47(暂无匿称), createdTime=Sun Nov 29 13:40:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44020, encodeId=459b4402057, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=31221666631, createdName=奔跑3225, createdTime=Sat Nov 28 12:33:00 CST 2015, time=2015-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497936, encodeId=469f149e9364e, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521564, encodeId=1ac7152156441, content=<a href='/topic/show?id=3c4e8985327' target=_blank style='color:#2F92EE;'>#血糖管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89853, encryptionId=3c4e8985327, topicName=血糖管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2da11366066, createdName=zhangying8792, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44000, encodeId=69df4400040, content=嘿嘿好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Nov 27 21:40:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43929, encodeId=227c4392961, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Thu Nov 26 21:06:00 CST 2015, time=2015-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43860, encodeId=2a4b438600b, content=对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后..., beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLB1WyQmmv2iazjCicO1CnvpCXOlCjJ1xJjmOQowmd5bSxCtVMicaZs7icQkxicMQCzTXgk8GEBKxnYuCxw/0, createdBy=ecf81608992, createdName=wxsessiond1c0d06a, createdTime=Thu Nov 26 10:12:00 CST 2015, time=2015-11-26, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=244624, encodeId=765624462455, content=dpp4抑制剂的低血糖发生率也是呈中性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33b02146058, createdName=Peter_sz, createdTime=Sat Sep 16 11:21:05 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798944, encodeId=51171e9894426, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Fri Jul 22 22:59:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44100, encodeId=1c0644100af, content=那阿卡波糖为CVD患者的首选降糖药了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8861654295, createdName=1ddd488dm47(暂无匿称), createdTime=Sun Nov 29 13:40:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44020, encodeId=459b4402057, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=31221666631, createdName=奔跑3225, createdTime=Sat Nov 28 12:33:00 CST 2015, time=2015-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497936, encodeId=469f149e9364e, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521564, encodeId=1ac7152156441, content=<a href='/topic/show?id=3c4e8985327' target=_blank style='color:#2F92EE;'>#血糖管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89853, encryptionId=3c4e8985327, topicName=血糖管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2da11366066, createdName=zhangying8792, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44000, encodeId=69df4400040, content=嘿嘿好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Nov 27 21:40:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43929, encodeId=227c4392961, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Thu Nov 26 21:06:00 CST 2015, time=2015-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43860, encodeId=2a4b438600b, content=对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后..., beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLB1WyQmmv2iazjCicO1CnvpCXOlCjJ1xJjmOQowmd5bSxCtVMicaZs7icQkxicMQCzTXgk8GEBKxnYuCxw/0, createdBy=ecf81608992, createdName=wxsessiond1c0d06a, createdTime=Thu Nov 26 10:12:00 CST 2015, time=2015-11-26, status=1, ipAttribution=)]
    2015-11-27 zwjnj2

    嘿嘿好学习了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=244624, encodeId=765624462455, content=dpp4抑制剂的低血糖发生率也是呈中性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33b02146058, createdName=Peter_sz, createdTime=Sat Sep 16 11:21:05 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798944, encodeId=51171e9894426, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Fri Jul 22 22:59:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44100, encodeId=1c0644100af, content=那阿卡波糖为CVD患者的首选降糖药了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8861654295, createdName=1ddd488dm47(暂无匿称), createdTime=Sun Nov 29 13:40:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44020, encodeId=459b4402057, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=31221666631, createdName=奔跑3225, createdTime=Sat Nov 28 12:33:00 CST 2015, time=2015-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497936, encodeId=469f149e9364e, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521564, encodeId=1ac7152156441, content=<a href='/topic/show?id=3c4e8985327' target=_blank style='color:#2F92EE;'>#血糖管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89853, encryptionId=3c4e8985327, topicName=血糖管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2da11366066, createdName=zhangying8792, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44000, encodeId=69df4400040, content=嘿嘿好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Nov 27 21:40:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43929, encodeId=227c4392961, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Thu Nov 26 21:06:00 CST 2015, time=2015-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43860, encodeId=2a4b438600b, content=对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后..., beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLB1WyQmmv2iazjCicO1CnvpCXOlCjJ1xJjmOQowmd5bSxCtVMicaZs7icQkxicMQCzTXgk8GEBKxnYuCxw/0, createdBy=ecf81608992, createdName=wxsessiond1c0d06a, createdTime=Thu Nov 26 10:12:00 CST 2015, time=2015-11-26, status=1, ipAttribution=)]
    2015-11-26 老段

    赞一个

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=244624, encodeId=765624462455, content=dpp4抑制剂的低血糖发生率也是呈中性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33b02146058, createdName=Peter_sz, createdTime=Sat Sep 16 11:21:05 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798944, encodeId=51171e9894426, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Fri Jul 22 22:59:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44100, encodeId=1c0644100af, content=那阿卡波糖为CVD患者的首选降糖药了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8861654295, createdName=1ddd488dm47(暂无匿称), createdTime=Sun Nov 29 13:40:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44020, encodeId=459b4402057, content=好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=31221666631, createdName=奔跑3225, createdTime=Sat Nov 28 12:33:00 CST 2015, time=2015-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497936, encodeId=469f149e9364e, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521564, encodeId=1ac7152156441, content=<a href='/topic/show?id=3c4e8985327' target=_blank style='color:#2F92EE;'>#血糖管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89853, encryptionId=3c4e8985327, topicName=血糖管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2da11366066, createdName=zhangying8792, createdTime=Fri Nov 27 23:59:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44000, encodeId=69df4400040, content=嘿嘿好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Nov 27 21:40:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43929, encodeId=227c4392961, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Thu Nov 26 21:06:00 CST 2015, time=2015-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43860, encodeId=2a4b438600b, content=对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后..., beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLB1WyQmmv2iazjCicO1CnvpCXOlCjJ1xJjmOQowmd5bSxCtVMicaZs7icQkxicMQCzTXgk8GEBKxnYuCxw/0, createdBy=ecf81608992, createdName=wxsessiond1c0d06a, createdTime=Thu Nov 26 10:12:00 CST 2015, time=2015-11-26, status=1, ipAttribution=)]
    2015-11-26 wxsessiond1c0d06a

    对CVD患者实施全面的5维血糖管理,有助于改善其心血管预后...

    0

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