BMJ：氟哌啶醇治疗与急性心肌梗死死亡风险

2018-04-02 zhangfan MedSci原创

研究发现，氟哌啶醇治疗导致的急性心肌梗死死亡风险略高于其他非典型抗精神病药物，虽然不能排除混淆因素，但心血管风险高危患者在使用氟哌啶醇时因充分考虑这一潜在风险

近日研究人员对因使用氟哌啶醇或其他非典型抗精神病药物导致的急性心肌梗死死亡事件进行了考察。

研究人员对英国700多家医院患者数据进行考察，6578名18岁以上因口服氟哌啶醇或非典型抗精神病药物（喹硫平，奥氮平和利培酮）导致的急性心肌梗死住院患者参与，研究的主要终点是7天内院内死亡。

患者平均年龄75.2岁，其中1668名患者服用了氟哌啶醇(25.4%)，4910 人(74.6%)服用了其他抗精神病药。意向分析发现，氟哌啶醇组每100患者天的绝对死亡1.7例(总计死亡患者数129例)，其他药物组为1.1例(92例)。7天内，氟哌啶醇组患者生存率为0.93，其他药物组为0.94。未调整和调整后的死亡风险分别为1.51和1.50，死亡相关风险在住院前4天最高，之后逐渐降低。

研究发现，氟哌啶醇治疗导致的急性心肌梗死死亡风险略高于其他非典型抗精神病药物，虽然不能排除混淆因素，但心血管风险高危患者在使用氟哌啶醇时因充分考虑这一潜在风险。

原始出处：

Yoonyoung Park et al. Use of haloperidol versus atypical antipsychotics and risk of in-hospital death in patients with acute myocardial infarction： cohort study. BMJ.28 March 2018.

本文系梅斯医学（MedSci）原创编译整理，转载需授权！

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 (6)

#插入话题

插入图片

[GetPortalCommentsPageByObjectIdResponse(id=1848495, encodeId=6f5c184849567, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 19 14:27:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255746, encodeId=bd841255e4606, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508440, encodeId=5cba150844059, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302051, encodeId=dcf030205159, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Apr 02 12:28:39 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302043, encodeId=d728302043dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Mon Apr 02 11:54:10 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302037, encodeId=21e330203e18, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Apr 02 11:42:55 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
2018-07-19 gaoxiaoe

#BMJ#

43 0
[GetPortalCommentsPageByObjectIdResponse(id=1848495, encodeId=6f5c184849567, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 19 14:27:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255746, encodeId=bd841255e4606, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508440, encodeId=5cba150844059, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302051, encodeId=dcf030205159, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Apr 02 12:28:39 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302043, encodeId=d728302043dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Mon Apr 02 11:54:10 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302037, encodeId=21e330203e18, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Apr 02 11:42:55 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
2018-04-04 quxin068

#死亡风险#

32 0
[GetPortalCommentsPageByObjectIdResponse(id=1848495, encodeId=6f5c184849567, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 19 14:27:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255746, encodeId=bd841255e4606, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508440, encodeId=5cba150844059, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302051, encodeId=dcf030205159, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Apr 02 12:28:39 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302043, encodeId=d728302043dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Mon Apr 02 11:54:10 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302037, encodeId=21e330203e18, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Apr 02 11:42:55 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
2018-04-04 venlin

#氟哌啶醇#

38 0
[GetPortalCommentsPageByObjectIdResponse(id=1848495, encodeId=6f5c184849567, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 19 14:27:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255746, encodeId=bd841255e4606, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508440, encodeId=5cba150844059, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302051, encodeId=dcf030205159, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Apr 02 12:28:39 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302043, encodeId=d728302043dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Mon Apr 02 11:54:10 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302037, encodeId=21e330203e18, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Apr 02 11:42:55 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
2018-04-02 yfjms

学习

82 0
[GetPortalCommentsPageByObjectIdResponse(id=1848495, encodeId=6f5c184849567, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 19 14:27:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255746, encodeId=bd841255e4606, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508440, encodeId=5cba150844059, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302051, encodeId=dcf030205159, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Apr 02 12:28:39 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302043, encodeId=d728302043dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Mon Apr 02 11:54:10 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302037, encodeId=21e330203e18, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Apr 02 11:42:55 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
2018-04-02 183****7028

学习

93 0
[GetPortalCommentsPageByObjectIdResponse(id=1848495, encodeId=6f5c184849567, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 19 14:27:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255746, encodeId=bd841255e4606, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508440, encodeId=5cba150844059, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Wed Apr 04 02:27:00 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302051, encodeId=dcf030205159, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Apr 02 12:28:39 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302043, encodeId=d728302043dd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Mon Apr 02 11:54:10 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302037, encodeId=21e330203e18, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Apr 02 11:42:55 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
2018-04-02 owlhealth

不错耶.学习了

80 0

内科

外科

专科科室

热点

按科室浏览

临床工具

科研工具

其他工具

科研数智化

真实世界研究解决方案

数字化学术传播解决方案

其它

心血管

BMJ：氟哌啶醇治疗与急性心肌梗死死亡风险

相关资讯

科室

工具

服务