Transl Psychiatry:青少年抑郁症患者的肾上腺激素水平

2022-08-13 从医路漫漫 MedSci原创

研究皮质醇与MDD的关系,特别是识别抑郁症亚型和预测复发的风险,已经成为研究的重点。

背景:抑郁症(MDD)是一种使人衰弱且非常普遍的精神疾病,在青少年时期的某个阶段影响多达20%的青少年。因此,人们对重性抑郁症(MDD)的生物标志物有相当大的兴趣,以识别MDD或其复发的风险个体,并通过明确的分类提供靶向治疗。为此,研究皮质醇与MDD的关系,特别是识别抑郁症亚型和预测复发的风险,已经成为研究的重点。在一项包含48项研究的荟合分析中,Juruena, Bocharova并没有指出抑郁症和非典型抑郁症患者之间的皮质醇水平和下丘脑-垂体-肾上腺(HPA)轴对药物挑战的反应性的差异。然而,荟萃分析也显示,皮质醇水平既不能预测对心理疗法或抗抑郁药的治疗效果。

然而,初步证据表明,肾上腺激素而非皮质醇可能有助于精神疾病的精准医疗。例如,有两项研究报道了11-脱氧皮质醇(皮质醇合成的前体物质,见图1)在成人抑郁症中分泌过多。此外,一系列依赖刺激和抑制试验的研究发现MDD中皮质酮分泌增加,地塞米松抑制试验(DST)被认为是通过药理学挑战诊断MDD的额外生化标准。然而,这些研究只包括6 - 36名患者,主要依赖于(非常)有限数量的肾上腺激素的测量。此外,在其中一些研究中,类固醇测量仅基于放射免疫分析,这容易与其他类固醇发生交叉反应。因此,尽管有希望,这些发现还需要证实。

除了肾上腺类固醇代谢组作为MDD诊断工具的潜力之外,它也可能有助于深入了解MDD的病理生理学。四氢脱氧皮质酮(THDOC)是一种神经活性类固醇,主要通过快速、主要是非基因组作用调节中枢神经系统(CNS)的活性,与抑郁症有关。虽然一些研究显示MDD中THDOC水平升高,但其肾上腺前体脱氧皮质酮在除产后抑郁症外的情绪障碍中几乎没有研究。考虑到THDOC水平的升高可能表明抑制HPA轴反馈回路受损,该信息也可以通过分析其前体脱氧皮质酮在肾上腺水平进行研究。此外,多种类固醇的联合检查可能会提供单一类固醇分析无法获得的临床意义的额外信息。例如,Goodyer等人。皮质醇与脱氢表雄酮比值的增加与MDD的前瞻性诊断以及青少年中MDD的持续存在相关。然而,在这方面还没有对其他类固醇比例进行研究。

目的:本横断研究旨在评估多种个体血清甾体激素(孕酮、17-羟基孕酮、21-脱氧皮质醇、11-脱氧皮质醇、皮质醇、可的松、脱氧皮质酮、皮质酮)的效用,并通过将大量临床抑郁青少年样本与年龄和性别匹配的参考队列进行比较,选择甾体比值作为MDD的肾上腺酶活性生物读出指标。本研究采用甾体激素分析的参照方法液相色谱-串联质谱(LC-MS/MS)进行甾体激素分析。考虑到上述对以往研究的回顾,我们假设肾上腺功能障碍会影响青少年重度抑郁症患者的糖皮质激素和矿糖皮质激素相关类固醇。

方法:采用液相色谱-串联质谱法测定在一家精神科医院治疗的261名抑郁青少年(170名女性)的血清肾上腺激素(孕酮、17-羟基孕酮、21-脱氧皮质醇、11-脱氧皮质醇、皮质醇、可的松、脱氧皮质酮、皮质酮)。研究结果通过非参数方差分析与年龄和性别匹配的参考队列(N = 255)进行比较。

结果:采用非参数受试者工作特征(ROC)分析评估单个类固醇激素的诊断性能和类固醇激素比例对抑郁状态的分类。敏感性分析考虑了肾上腺功能的重要混杂因素,ROC结果通过交叉验证进行验证。与参考队列相比,脱氧皮质酮和21-脱氧皮质醇水平降低(P < 0.001)。其他所有糖皮质激素和矿糖皮质激素相关类固醇均增加(P < 0.001)。皮质酮与脱氧皮质酮的比值证明了优秀的分类特征,尤其是在女性(AUC: 0.957;灵敏度:0.902;特异性:0.891)。

图1 所有类固醇和类固醇比例的箱线图。图(A)显示类固醇激素和类固醇激素的比例,图(B)显示与性别无关的激素比例,分别为参考队列和患有MDD的青少年(x轴)。y轴对应单个甾体的nmol/l,与甾体比例无关。注意,B值和皮质醇/11-脱氧皮质醇、脱氧皮质酮/孕酮和皮质酮/脱氧皮质酮的比值(超过四分位数范围的三倍)不显示极端异常值,以避免y轴和较低范围数值的图形表示失真。

表1 患者特征。

表2 类固醇和类固醇比率—结果

表3排序的方差分析结果

表4 ROC结果

图2皮质酮/脱氧皮质酮的ROC曲线。男性和女性的结果是分开显示的。

结论:肾上腺类固醇代谢组可以作为反映青少年重度抑郁症的生物读出器,通过一种明显的类固醇模式来表明下丘脑-垂体-肾上腺轴的功能障碍。此外,皮质酮与脱氧皮质酮的比例可能有助于精神病学的精准医疗,通过确定哪些患者可能受益于糖皮质激素治疗,或那些在肾上腺功能障碍尚未解决时有复发风险的患者。

原文出处:Hirtz R,  Libuda L,  Hinney A,et al.The adrenal steroid profile in adolescent depression: a valuable bio-readout?Transl Psychiatry 2022 Jun 18;12(1)

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (7)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2067639, encodeId=1873206e63923, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Jun 13 22:26:04 CST 2023, time=2023-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988628, encodeId=f1c91988628a9, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Fri Mar 31 11:26:04 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657667, encodeId=90cb165e667df, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Apr 30 03:26:04 CST 2023, time=2023-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792331, encodeId=aa6d1e923315f, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Mar 03 22:26:04 CST 2023, time=2023-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998345, encodeId=6dd11998345af, content=<a href='/topic/show?id=499c6683554' target=_blank style='color:#2F92EE;'>#激素水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66835, encryptionId=499c6683554, topicName=激素水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sat Oct 29 21:26:04 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895263, encodeId=62eb1895263b9, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Fri Jun 23 05:26:04 CST 2023, time=2023-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238475, encodeId=653312384e5e5, content=学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Aug 13 15:19:17 CST 2022, time=2022-08-13, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2067639, encodeId=1873206e63923, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Jun 13 22:26:04 CST 2023, time=2023-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988628, encodeId=f1c91988628a9, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Fri Mar 31 11:26:04 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657667, encodeId=90cb165e667df, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Apr 30 03:26:04 CST 2023, time=2023-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792331, encodeId=aa6d1e923315f, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Mar 03 22:26:04 CST 2023, time=2023-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998345, encodeId=6dd11998345af, content=<a href='/topic/show?id=499c6683554' target=_blank style='color:#2F92EE;'>#激素水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66835, encryptionId=499c6683554, topicName=激素水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sat Oct 29 21:26:04 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895263, encodeId=62eb1895263b9, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Fri Jun 23 05:26:04 CST 2023, time=2023-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238475, encodeId=653312384e5e5, content=学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Aug 13 15:19:17 CST 2022, time=2022-08-13, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2067639, encodeId=1873206e63923, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Jun 13 22:26:04 CST 2023, time=2023-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988628, encodeId=f1c91988628a9, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Fri Mar 31 11:26:04 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657667, encodeId=90cb165e667df, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Apr 30 03:26:04 CST 2023, time=2023-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792331, encodeId=aa6d1e923315f, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Mar 03 22:26:04 CST 2023, time=2023-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998345, encodeId=6dd11998345af, content=<a href='/topic/show?id=499c6683554' target=_blank style='color:#2F92EE;'>#激素水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66835, encryptionId=499c6683554, topicName=激素水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sat Oct 29 21:26:04 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895263, encodeId=62eb1895263b9, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Fri Jun 23 05:26:04 CST 2023, time=2023-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238475, encodeId=653312384e5e5, content=学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Aug 13 15:19:17 CST 2022, time=2022-08-13, status=1, ipAttribution=)]
    2023-04-30 bsmagic9140
  4. [GetPortalCommentsPageByObjectIdResponse(id=2067639, encodeId=1873206e63923, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Jun 13 22:26:04 CST 2023, time=2023-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988628, encodeId=f1c91988628a9, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Fri Mar 31 11:26:04 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657667, encodeId=90cb165e667df, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Apr 30 03:26:04 CST 2023, time=2023-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792331, encodeId=aa6d1e923315f, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Mar 03 22:26:04 CST 2023, time=2023-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998345, encodeId=6dd11998345af, content=<a href='/topic/show?id=499c6683554' target=_blank style='color:#2F92EE;'>#激素水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66835, encryptionId=499c6683554, topicName=激素水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sat Oct 29 21:26:04 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895263, encodeId=62eb1895263b9, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Fri Jun 23 05:26:04 CST 2023, time=2023-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238475, encodeId=653312384e5e5, content=学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Aug 13 15:19:17 CST 2022, time=2022-08-13, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2067639, encodeId=1873206e63923, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Jun 13 22:26:04 CST 2023, time=2023-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988628, encodeId=f1c91988628a9, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Fri Mar 31 11:26:04 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657667, encodeId=90cb165e667df, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Apr 30 03:26:04 CST 2023, time=2023-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792331, encodeId=aa6d1e923315f, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Mar 03 22:26:04 CST 2023, time=2023-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998345, encodeId=6dd11998345af, content=<a href='/topic/show?id=499c6683554' target=_blank style='color:#2F92EE;'>#激素水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66835, encryptionId=499c6683554, topicName=激素水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sat Oct 29 21:26:04 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895263, encodeId=62eb1895263b9, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Fri Jun 23 05:26:04 CST 2023, time=2023-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238475, encodeId=653312384e5e5, content=学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Aug 13 15:19:17 CST 2022, time=2022-08-13, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2067639, encodeId=1873206e63923, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Jun 13 22:26:04 CST 2023, time=2023-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988628, encodeId=f1c91988628a9, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Fri Mar 31 11:26:04 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657667, encodeId=90cb165e667df, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Apr 30 03:26:04 CST 2023, time=2023-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792331, encodeId=aa6d1e923315f, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Mar 03 22:26:04 CST 2023, time=2023-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998345, encodeId=6dd11998345af, content=<a href='/topic/show?id=499c6683554' target=_blank style='color:#2F92EE;'>#激素水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66835, encryptionId=499c6683554, topicName=激素水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sat Oct 29 21:26:04 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895263, encodeId=62eb1895263b9, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Fri Jun 23 05:26:04 CST 2023, time=2023-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238475, encodeId=653312384e5e5, content=学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Aug 13 15:19:17 CST 2022, time=2022-08-13, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2067639, encodeId=1873206e63923, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Jun 13 22:26:04 CST 2023, time=2023-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988628, encodeId=f1c91988628a9, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Fri Mar 31 11:26:04 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657667, encodeId=90cb165e667df, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Apr 30 03:26:04 CST 2023, time=2023-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792331, encodeId=aa6d1e923315f, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Fri Mar 03 22:26:04 CST 2023, time=2023-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998345, encodeId=6dd11998345af, content=<a href='/topic/show?id=499c6683554' target=_blank style='color:#2F92EE;'>#激素水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66835, encryptionId=499c6683554, topicName=激素水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Sat Oct 29 21:26:04 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895263, encodeId=62eb1895263b9, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Fri Jun 23 05:26:04 CST 2023, time=2023-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238475, encodeId=653312384e5e5, content=学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Aug 13 15:19:17 CST 2022, time=2022-08-13, status=1, ipAttribution=)]
    2022-08-13 ms5000000518166734

    学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习

    0