Lancet子刊:老年女性收缩压低于120 mmHg,更有益大脑健康,减少认知障碍!

2022-02-11 MedSci原创 MedSci原创

将老年女性高血压患者的收缩压治疗目标值定为低于120 mmHg不仅相对安全,且对其认知健康具有重要保护作用。研究结果支持老年女性高血压患者进行强化血压管理,即收缩压降压目标需低于120 mmHg(或脉

既往研究表明,高血压是认知障碍以及痴呆症最重要的危险因素之一。然而,如何更好地进行血压管理,从而预防老年人群认知障碍与痴呆症的发生,目前仍然存在巨大争议。老年高血压患者是否有必要设立更低的目标血压值?更大幅度地降低老年患者血压是否安全、有效?是否会带来如卒中、认知恶化、晕厥或其他不良事件?

目前如美国心脏病学会(ACC)、美国心脏协会(AHA)等发布的临床血压管理指南均指出:降低高血压患者血压或将有助于预防认知功能下降以及痴呆症的发生,但这些指南均未针对此设立明确降压目标。收缩压干预试验(SPRINT)的结果表明,与标准治疗目标(将收缩压控制在<140 mmHg)相比,将高血压患者收缩压控制在120 mmHg以下不仅相对安全,且能潜在改善患者发生轻度认知障碍以及痴呆症的可能性。但截至目前,针对老年女性这部分群体,尚未有权威性随机对照试验或观察性研究探索其血压与认知之间的关系。

近日,来自美国德雷塞尔大学的研究团队于期刊《柳叶刀-健康长寿》(The Lancet Healthy Longevity)发表了老年女性血压与认知障碍之间关联的研究探索成果。这项名为WHIMS的队列研究数据来自女性健康倡议(WHI)研究。

这项名为WHIMS的研究共纳入7207例美国39个不同医学中心的女性受试者(年龄:65~79岁;伴有或不伴有高血压),招募时间为1996年5月至1999年12月。

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Object name is nihms-1773122-f0001.jpg

研究人员基于其基线血压(包括脉压)数据及每年认知功能评分,探索了血压以及降压治疗与老年女性轻度认知障碍以及痴呆症发生之间的关系。

▲老年女性受试者基线数据

研究主要终点为轻度认知障碍、可能性痴呆以及认知损伤(轻度认知损害与可能性痴呆复合症状)。随访截止时间为2019年12月。

中位随访9年的分析数据显示:

  • 在随访期间,15.7%的受试者被归类为轻度认知障碍、10.3%的受试者被归类为可能性痴呆、21.3%的受试者被归类为认知损伤;

  • 根据当前数据评估,老年女性人群中轻度认知障碍的发病率为15.3/1000人年、痴呆症的发病率为9.7/1000人年、认知损伤的发病率为20.3/1000人年;

  • 收缩压或脉压的升高与轻度认知障碍或认知损伤发生风险升高显著相关 (p<0.01);

  • 与此同时,接受降压治疗后收缩压低于120 mmHg的高血压受试者对比血压正常的受试者,其轻度认知障碍(HR=1.33, 95%CI 0.98–1.82; p=0.071)或认知损伤(HR=1.09, 95%CI 0.82–1.44; p=0.57)的发生风险并未显著升高;

  • 对于接受降压治疗且脉压低于50 mmHg的受试者而言,其轻度认知障碍(HR=1.26, 95%CI 0.98–1.62; p=0.07)或认知损伤(HR=1.17, 95%CI 0.94–1.46; p=0.16)的发生风险并未显著升高;

  • 高血压、收缩压或脉压差(PP)与可能性痴呆的发生之间不存在显著相关性。

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Object name is nihms-1773122-f0002.jpg
图:收缩压和脉压差对认知丧失和轻度认知损害的关系

总体而言,将老年女性高血压患者的收缩压治疗目标值定为低于120 mmHg不仅相对安全,且对其认知健康具有重要保护作用。研究结果支持老年女性高血压患者进行强化血压管理,即收缩压降压目标需低于120 mmHg(或脉压低于50 mmHg)。

当然,本研究也存在一定的局限性,如纳入的受试者主要为白色人种、未收集受试者中年血压相应数据等。

此外,研究显示,高血压、收缩压或脉压升高与可能性痴呆的发生之间似乎存在相关性,但该相关性并未达到显著性差异,这或许与诊断为可能性痴呆的患者样本量较小有关。同期评论文章强调,当前研究基于基线平均收缩压和脉压等指标对血压与认知之间的关系进行分析。

需要指出的是,目前还有多种指标可用于衡量与分析血压,相对研究中采取的单次基线测量,明确血压随治疗时间变化对认知的持续影响将具有更加重要意义。而除血压测量指标外,我们也有必要关注降压治疗的药物种类。

目前医生倾向于使用血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体阻滞剂进行降压治疗,但在认知持续改善方面,哪类降压药物能带来更多获益,目前尚未有充足证据,这些都值得未来进一步探索。

原始出处:

Liu L, Hayden KM, May NS, Haring B, Liu Z, Henderson VW, Chen JC, Gracely EJ, Wassertheil-Smoller S, Rapp SR.Association between blood pressure levels and cognitive impairment in older women: a prospective analysis of the Women's Health Initiative Memory Study.Lancet Healthy Longev. 2022 Jan;3(1):e42-e53

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    2022-06-14 howi
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1971209, encodeId=e70419e12092b, content=<a href='/topic/show?id=899a4386990' target=_blank style='color:#2F92EE;'>#大脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43869, encryptionId=899a4386990, topicName=大脑健康)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69cb413, createdName=chengjn, createdTime=Sat Feb 26 03:11:55 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831465, encodeId=062b18314658f, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jun 14 18:11:55 CST 2022, time=2022-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1840375, encodeId=a07818403e528, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Fri Aug 19 05:11:55 CST 2022, time=2022-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626130, encodeId=f8761626130d0, content=<a href='/topic/show?id=24cd84e0663' target=_blank style='color:#2F92EE;'>#脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84706, encryptionId=24cd84e0663, topicName=脑健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=468920981914, createdName=lancelotzzl, createdTime=Tue Feb 15 02:11:55 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192995, encodeId=af2f119299529, content=这和以往认知可不同了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Feb 13 16:41:27 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192981, encodeId=70021192981bd, content=很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7062537747, createdName=1251577cm81暂无昵称, createdTime=Sun Feb 13 16:07:35 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192978, encodeId=7d4e11929e88d, content=血压测量如何保证准确统一?, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee1e2790161, createdName=ye1982yi, createdTime=Sun Feb 13 15:35:22 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192953, encodeId=d0e911929538f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/03/28/bf853922118e52118728acccb370109f.jpg, createdBy=dc3e2043338, createdName=1351ea2ae0m, createdTime=Sun Feb 13 13:49:21 CST 2022, time=2022-02-13, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1971209, encodeId=e70419e12092b, content=<a href='/topic/show?id=899a4386990' target=_blank style='color:#2F92EE;'>#大脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43869, encryptionId=899a4386990, topicName=大脑健康)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69cb413, createdName=chengjn, createdTime=Sat Feb 26 03:11:55 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831465, encodeId=062b18314658f, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jun 14 18:11:55 CST 2022, time=2022-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1840375, encodeId=a07818403e528, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Fri Aug 19 05:11:55 CST 2022, time=2022-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626130, encodeId=f8761626130d0, content=<a href='/topic/show?id=24cd84e0663' target=_blank style='color:#2F92EE;'>#脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84706, encryptionId=24cd84e0663, topicName=脑健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=468920981914, createdName=lancelotzzl, createdTime=Tue Feb 15 02:11:55 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192995, encodeId=af2f119299529, content=这和以往认知可不同了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Feb 13 16:41:27 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192981, encodeId=70021192981bd, content=很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7062537747, createdName=1251577cm81暂无昵称, createdTime=Sun Feb 13 16:07:35 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192978, encodeId=7d4e11929e88d, content=血压测量如何保证准确统一?, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee1e2790161, createdName=ye1982yi, createdTime=Sun Feb 13 15:35:22 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192953, encodeId=d0e911929538f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/03/28/bf853922118e52118728acccb370109f.jpg, createdBy=dc3e2043338, createdName=1351ea2ae0m, createdTime=Sun Feb 13 13:49:21 CST 2022, time=2022-02-13, status=1, ipAttribution=)]
    2022-02-13 carrotlyl

    这和以往认知可不同了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1971209, encodeId=e70419e12092b, content=<a href='/topic/show?id=899a4386990' target=_blank style='color:#2F92EE;'>#大脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43869, encryptionId=899a4386990, topicName=大脑健康)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69cb413, createdName=chengjn, createdTime=Sat Feb 26 03:11:55 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831465, encodeId=062b18314658f, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jun 14 18:11:55 CST 2022, time=2022-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1840375, encodeId=a07818403e528, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Fri Aug 19 05:11:55 CST 2022, time=2022-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626130, encodeId=f8761626130d0, content=<a href='/topic/show?id=24cd84e0663' target=_blank style='color:#2F92EE;'>#脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84706, encryptionId=24cd84e0663, topicName=脑健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=468920981914, createdName=lancelotzzl, createdTime=Tue Feb 15 02:11:55 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192995, encodeId=af2f119299529, content=这和以往认知可不同了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Feb 13 16:41:27 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192981, encodeId=70021192981bd, content=很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7062537747, createdName=1251577cm81暂无昵称, createdTime=Sun Feb 13 16:07:35 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192978, encodeId=7d4e11929e88d, content=血压测量如何保证准确统一?, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee1e2790161, createdName=ye1982yi, createdTime=Sun Feb 13 15:35:22 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192953, encodeId=d0e911929538f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/03/28/bf853922118e52118728acccb370109f.jpg, createdBy=dc3e2043338, createdName=1351ea2ae0m, createdTime=Sun Feb 13 13:49:21 CST 2022, time=2022-02-13, status=1, ipAttribution=)]
    2022-02-13 1251577cm81暂无昵称

    很实用

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1971209, encodeId=e70419e12092b, content=<a href='/topic/show?id=899a4386990' target=_blank style='color:#2F92EE;'>#大脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43869, encryptionId=899a4386990, topicName=大脑健康)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69cb413, createdName=chengjn, createdTime=Sat Feb 26 03:11:55 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831465, encodeId=062b18314658f, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jun 14 18:11:55 CST 2022, time=2022-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1840375, encodeId=a07818403e528, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Fri Aug 19 05:11:55 CST 2022, time=2022-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626130, encodeId=f8761626130d0, content=<a href='/topic/show?id=24cd84e0663' target=_blank style='color:#2F92EE;'>#脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84706, encryptionId=24cd84e0663, topicName=脑健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=468920981914, createdName=lancelotzzl, createdTime=Tue Feb 15 02:11:55 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192995, encodeId=af2f119299529, content=这和以往认知可不同了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Feb 13 16:41:27 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192981, encodeId=70021192981bd, content=很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7062537747, createdName=1251577cm81暂无昵称, createdTime=Sun Feb 13 16:07:35 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192978, encodeId=7d4e11929e88d, content=血压测量如何保证准确统一?, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee1e2790161, createdName=ye1982yi, createdTime=Sun Feb 13 15:35:22 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192953, encodeId=d0e911929538f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/03/28/bf853922118e52118728acccb370109f.jpg, createdBy=dc3e2043338, createdName=1351ea2ae0m, createdTime=Sun Feb 13 13:49:21 CST 2022, time=2022-02-13, status=1, ipAttribution=)]
    2022-02-13 ye1982yi

    血压测量如何保证准确统一?

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1971209, encodeId=e70419e12092b, content=<a href='/topic/show?id=899a4386990' target=_blank style='color:#2F92EE;'>#大脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43869, encryptionId=899a4386990, topicName=大脑健康)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69cb413, createdName=chengjn, createdTime=Sat Feb 26 03:11:55 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831465, encodeId=062b18314658f, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jun 14 18:11:55 CST 2022, time=2022-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1840375, encodeId=a07818403e528, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Fri Aug 19 05:11:55 CST 2022, time=2022-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626130, encodeId=f8761626130d0, content=<a href='/topic/show?id=24cd84e0663' target=_blank style='color:#2F92EE;'>#脑健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84706, encryptionId=24cd84e0663, topicName=脑健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=468920981914, createdName=lancelotzzl, createdTime=Tue Feb 15 02:11:55 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192995, encodeId=af2f119299529, content=这和以往认知可不同了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Sun Feb 13 16:41:27 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192981, encodeId=70021192981bd, content=很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7062537747, createdName=1251577cm81暂无昵称, createdTime=Sun Feb 13 16:07:35 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192978, encodeId=7d4e11929e88d, content=血压测量如何保证准确统一?, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee1e2790161, createdName=ye1982yi, createdTime=Sun Feb 13 15:35:22 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192953, encodeId=d0e911929538f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/03/28/bf853922118e52118728acccb370109f.jpg, createdBy=dc3e2043338, createdName=1351ea2ae0m, createdTime=Sun Feb 13 13:49:21 CST 2022, time=2022-02-13, status=1, ipAttribution=)]
    2022-02-13 1351ea2ae0m

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