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Chest：静脉注射免疫球蛋白治疗严重难治性肝素诱发的血小板减少症！

2017-04-21 xing.T MedSci原创

HITIVIG血栓栓塞
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这些研究表明，对标准疗法无效且伴有严重疾病的HIT患者应考虑IVIg治疗。

肝素诱发的血小板减少症（HIT）合并严重的血小板减少和血栓形成为治疗到来了重大的挑战。在这种情况下使用替代抗凝剂可能会增加出血风险，尤其是那些有长期病程的患者。在这严重受影响的患者人群中缺乏额外的治疗方法。

近日，胸部疾病领域权威杂志Chest杂志上发表了一篇研究文章，研究人员描述了三例经标准治疗无效的严重血栓栓塞和长期血小板减少症患者，但对静脉注射免疫球蛋白G（IVIg）治疗有直接和持续的反应。研究人员对这3个患者和额外的5个重度HIT患者的IVIg作用机制进行了评估。研究人员分析了血小板IgG受体FcγRIIa常见的多态性（131H/R）对IVIg介导的血小板活化抑制作用的影响。

在体内，IVIg抑制HIT抗体介导的血小板活化。IgG的恒定区（Fc），而不是抗原结合部分（Fab），介导了这种效果。与这一结果相一致，IVIg对固相HIT免疫实验（PF4 ELISA）中HIT抗体结合无影响。在FcγRIIa的多态性R/H131影响了血小板对IVIg治疗的易感性，HH131基因型是最易受IVIg介导对抗体诱导激活抑制的影响。然而，高剂量的IVIg治疗，对所有血小板激活的FCγRIIa基因型是明显抑制。所有3例患者对直接口服抗凝药物（DOACs）的长期抗凝治疗反应良好。

这些研究表明，对标准疗法无效且伴有严重疾病的HIT患者应考虑IVIg治疗。

原始出处：

Anand Padmanabhan,et al. Intravenous immunoglobulin for treatment of severe refractory heparin-induced thrombocytopenia.Chest. 2017. http://journal.publications.chestnet.org/article.aspx?articleid=2622869

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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, 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    2020-09-14 辣妈

    学习了，谢谢

    0

  2. 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    2017-07-20 xzw113

    #球蛋白#

    0

  3. 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    2018-01-23 Smile2680

    #Chest#

    0

  4. 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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492459, encodeId=0b9c1492459e2, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528341, encodeId=dd6c1528341e0, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-10-11 xiangyuzhou971

    #EST#

    0

  5. 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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492459, encodeId=0b9c1492459e2, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528341, encodeId=dd6c1528341e0, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-07-19 fusion

    #静脉#

    0

  6. 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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492459, encodeId=0b9c1492459e2, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528341, encodeId=dd6c1528341e0, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-24 laymankey

    感谢分享一下！！

    0

  7. 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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492459, encodeId=0b9c1492459e2, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528341, encodeId=dd6c1528341e0, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-23 nymo

    #免疫球蛋白#

    0

  8. 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21:03:00 CST 2017, time=2017-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929316, encodeId=1419192931634, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Jan 23 20:03:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050655, encodeId=4da82050655cc, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, 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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492459, encodeId=0b9c1492459e2, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528341, encodeId=dd6c1528341e0, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-23 lingaifan

    #血小板减少#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=885245, encodeId=878488524545, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200528/711fef9341494fb6834d0e538da9f0fd/e664e9c3069f440f81a8366cd79ba689.jpg, createdBy=c53a5341038, createdName=辣妈, createdTime=Mon Sep 14 19:29:37 CST 2020, time=2020-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2035137, encodeId=3972203513e97, content=<a href='/topic/show?id=5a426866eae' target=_blank style='color:#2F92EE;'>#球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68667, encryptionId=5a426866eae, topicName=球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Thu Jul 20 21:03:00 CST 2017, time=2017-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929316, encodeId=1419192931634, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Jan 23 20:03:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050655, encodeId=4da82050655cc, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, 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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492459, encodeId=0b9c1492459e2, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528341, encodeId=dd6c1528341e0, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-23 millore

    #静脉注射#

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=885245, encodeId=878488524545, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200528/711fef9341494fb6834d0e538da9f0fd/e664e9c3069f440f81a8366cd79ba689.jpg, createdBy=c53a5341038, createdName=辣妈, createdTime=Mon Sep 14 19:29:37 CST 2020, time=2020-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2035137, encodeId=3972203513e97, content=<a href='/topic/show?id=5a426866eae' target=_blank style='color:#2F92EE;'>#球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68667, encryptionId=5a426866eae, topicName=球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Thu Jul 20 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createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Mon Apr 24 23:43:10 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283875, encodeId=3bff12838e5b6, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302760, encodeId=6e0b1302e604a, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492459, encodeId=0b9c1492459e2, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528341, encodeId=dd6c1528341e0, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Apr 23 02:03:00 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-23 freve

    #难治性#

    0

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