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Lancet:阿司匹林联合质子泵抑制剂可有效降低抗血小板治疗的出血风险

2017-06-14 zhangfan MedSci原创

对于未联用质子泵抑制剂的接受阿司匹林基础的抗血小板治疗患者,长期治疗大出血及致残致死出血风险高。应鼓励质子泵抑制剂与阿司匹林在抗血小板治疗中的联用,特别是75岁以上的老年人

根据75岁以下患者的临床试验,在缺血性血管事件后建议给予终生的抗血小板治疗。虽然阿司匹林会导致上消化道出血这一严重的并发症,但病死率低且一般不会导致残疾。研究表明质子泵抑制剂(PPI)与阿司匹林共同处方可减少70–90%上消化道出血,但其吸收差学术界对其应用尚存在争议。近日研究人员对所有年龄段的患者二级抗血小板治疗出血预防的风险、时间和出血的结果进行评估。

研究人员对采用抗血小板药物治疗的短暂性脑缺血发作、缺血性卒中心肌梗死患者进行了前瞻性人群队列研究。患者的抗血小板治疗以阿司匹林为基础,没有常规PPI使用,研究期间为2002-12年,随访至2013年。通过10年的研究确定出血需要就医的类型、严重程度、预后(伤残或死亡)和时间历程。研究人员通过卡普兰-迈耶风险估计和相对风险减少估计的方法评估年龄特异的需要治疗人群(NNT)预防上消化道出血与PPI共处方之间的关系。

在12509个患者随访年中,3166名随访者中,有1582人(50%)发生了405起首次出血事件(其中胃出血218起,颅内出血45起,其他出血142起),其中314名(78%) 患者入院,117人(37%)未获得相关信息。非大出血风险与年龄无关,但大出血风险随着年龄的增长而急剧增加(≥75岁,HR 3.10,95%,CI,2.27-4.24),特别是致命出血风险(5.53,2.65-11.54)。胃肠道出血风险极高(≥75 years HR 4.13, 2.60–6.57; p<0.0001), 致残或致死风险高(10.26, 4.37–24.13; p<0·0001)对于75岁以上患者,上消化道出血主要导致患者致残或致死(62%vs47%,上消化道出血vs中风),并导致严重致残或致死性脑出血(45例vs18例),绝对风险为9.15每1000患者年 (95% CI 6.67–12.24)。常规的PPI共处方可降低患者5年致残或致死性上消化道出血风险,65岁以下的需要治疗人群(NNT)下降至338,85岁以上下降至25。

研究发现,对于未联用质子泵抑制剂的接受阿司匹林基础的抗血小板治疗患者,长期治疗大出血及致残致死出血风险高。应鼓励质子泵抑制剂与阿司匹林在抗血小板治疗中的联用,特别是75岁以上的老年人。

原始出处:


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    2017-12-27 jklm09
  2. 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    2018-02-28 howi
  4. [GetPortalCommentsPageByObjectIdResponse(id=1851461, encodeId=145a185146197, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Dec 27 10:17:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667330, encodeId=0323166e33034, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Jun 19 22:17:00 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829012, encodeId=26f1182901212, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Feb 28 18:17:00 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215509, encodeId=de84215509cf, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Mon Jun 26 07:54:23 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211545, encodeId=56bd211545ef, content=可能改变指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4cd1660740, createdName=dachengl, createdTime=Fri Jun 16 12:45:34 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211260, encodeId=f34321126071, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220317/1c3b2db4747d42e88e5018b394979434/be0fcebf07344e9ab886c37c502e2f29.jpg, createdBy=6bb22051299, createdName=微笑人参, createdTime=Thu Jun 15 22:46:51 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211173, encodeId=e3572111e393, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jun 15 17:36:47 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210883, encodeId=0c032108832a, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu Jun 15 06:24:14 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210697, encodeId=96c221069ef7, content=ppi种类多,都OK吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Wed Jun 14 15:49:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210691, encodeId=742521069154, content=是否会导致质子泵抑制剂过多应用呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Ne59unJiaEKVBVsw2H5iaLnmLt108lIrJ6YTqVphNiao7iaUJuuRE3xickhLErmQ99C3vF1zsf7DKXibuAQLOMjy7cgqj/0, createdBy=a8102049538, createdName=Medsci0421, createdTime=Wed Jun 14 14:59:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-26 lofter

    学习了感谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1851461, encodeId=145a185146197, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Dec 27 10:17:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667330, encodeId=0323166e33034, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Jun 19 22:17:00 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829012, encodeId=26f1182901212, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Feb 28 18:17:00 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215509, encodeId=de84215509cf, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Mon Jun 26 07:54:23 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211545, encodeId=56bd211545ef, content=可能改变指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4cd1660740, createdName=dachengl, createdTime=Fri Jun 16 12:45:34 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211260, encodeId=f34321126071, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220317/1c3b2db4747d42e88e5018b394979434/be0fcebf07344e9ab886c37c502e2f29.jpg, createdBy=6bb22051299, createdName=微笑人参, createdTime=Thu Jun 15 22:46:51 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211173, encodeId=e3572111e393, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jun 15 17:36:47 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210883, encodeId=0c032108832a, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu Jun 15 06:24:14 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210697, encodeId=96c221069ef7, content=ppi种类多,都OK吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Wed Jun 14 15:49:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210691, encodeId=742521069154, content=是否会导致质子泵抑制剂过多应用呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Ne59unJiaEKVBVsw2H5iaLnmLt108lIrJ6YTqVphNiao7iaUJuuRE3xickhLErmQ99C3vF1zsf7DKXibuAQLOMjy7cgqj/0, createdBy=a8102049538, createdName=Medsci0421, createdTime=Wed Jun 14 14:59:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-16 dachengl

    可能改变指南

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1851461, encodeId=145a185146197, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Dec 27 10:17:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667330, encodeId=0323166e33034, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Jun 19 22:17:00 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829012, encodeId=26f1182901212, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Feb 28 18:17:00 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215509, encodeId=de84215509cf, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Mon Jun 26 07:54:23 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211545, encodeId=56bd211545ef, content=可能改变指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4cd1660740, createdName=dachengl, createdTime=Fri Jun 16 12:45:34 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211260, encodeId=f34321126071, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220317/1c3b2db4747d42e88e5018b394979434/be0fcebf07344e9ab886c37c502e2f29.jpg, createdBy=6bb22051299, createdName=微笑人参, createdTime=Thu Jun 15 22:46:51 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211173, encodeId=e3572111e393, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jun 15 17:36:47 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210883, encodeId=0c032108832a, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu Jun 15 06:24:14 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210697, encodeId=96c221069ef7, content=ppi种类多,都OK吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Wed Jun 14 15:49:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210691, encodeId=742521069154, content=是否会导致质子泵抑制剂过多应用呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Ne59unJiaEKVBVsw2H5iaLnmLt108lIrJ6YTqVphNiao7iaUJuuRE3xickhLErmQ99C3vF1zsf7DKXibuAQLOMjy7cgqj/0, createdBy=a8102049538, createdName=Medsci0421, createdTime=Wed Jun 14 14:59:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-15 微笑人参

    学习了学习了

    0

  7. 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    2017-06-15 thlabcde

    好东西学习了!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1851461, encodeId=145a185146197, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Dec 27 10:17:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667330, encodeId=0323166e33034, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Jun 19 22:17:00 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829012, encodeId=26f1182901212, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Feb 28 18:17:00 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215509, encodeId=de84215509cf, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Mon Jun 26 07:54:23 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211545, encodeId=56bd211545ef, content=可能改变指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4cd1660740, createdName=dachengl, createdTime=Fri Jun 16 12:45:34 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211260, encodeId=f34321126071, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220317/1c3b2db4747d42e88e5018b394979434/be0fcebf07344e9ab886c37c502e2f29.jpg, createdBy=6bb22051299, createdName=微笑人参, createdTime=Thu Jun 15 22:46:51 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211173, encodeId=e3572111e393, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jun 15 17:36:47 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210883, encodeId=0c032108832a, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu Jun 15 06:24:14 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210697, encodeId=96c221069ef7, content=ppi种类多,都OK吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Wed Jun 14 15:49:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210691, encodeId=742521069154, content=是否会导致质子泵抑制剂过多应用呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Ne59unJiaEKVBVsw2H5iaLnmLt108lIrJ6YTqVphNiao7iaUJuuRE3xickhLErmQ99C3vF1zsf7DKXibuAQLOMjy7cgqj/0, createdBy=a8102049538, createdName=Medsci0421, createdTime=Wed Jun 14 14:59:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-15 meiliwuxian

    学习了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1851461, encodeId=145a185146197, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Dec 27 10:17:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667330, encodeId=0323166e33034, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Jun 19 22:17:00 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829012, encodeId=26f1182901212, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Feb 28 18:17:00 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215509, encodeId=de84215509cf, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Mon Jun 26 07:54:23 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211545, encodeId=56bd211545ef, content=可能改变指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4cd1660740, createdName=dachengl, createdTime=Fri Jun 16 12:45:34 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211260, encodeId=f34321126071, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220317/1c3b2db4747d42e88e5018b394979434/be0fcebf07344e9ab886c37c502e2f29.jpg, createdBy=6bb22051299, createdName=微笑人参, createdTime=Thu Jun 15 22:46:51 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211173, encodeId=e3572111e393, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jun 15 17:36:47 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210883, encodeId=0c032108832a, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu Jun 15 06:24:14 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210697, encodeId=96c221069ef7, content=ppi种类多,都OK吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Wed Jun 14 15:49:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210691, encodeId=742521069154, content=是否会导致质子泵抑制剂过多应用呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Ne59unJiaEKVBVsw2H5iaLnmLt108lIrJ6YTqVphNiao7iaUJuuRE3xickhLErmQ99C3vF1zsf7DKXibuAQLOMjy7cgqj/0, createdBy=a8102049538, createdName=Medsci0421, createdTime=Wed Jun 14 14:59:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 baihao215

    ppi种类多,都OK吗?

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1851461, encodeId=145a185146197, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Dec 27 10:17:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667330, encodeId=0323166e33034, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Jun 19 22:17:00 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829012, encodeId=26f1182901212, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed Feb 28 18:17:00 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215509, encodeId=de84215509cf, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Mon Jun 26 07:54:23 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211545, encodeId=56bd211545ef, content=可能改变指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4cd1660740, createdName=dachengl, createdTime=Fri Jun 16 12:45:34 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211260, encodeId=f34321126071, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220317/1c3b2db4747d42e88e5018b394979434/be0fcebf07344e9ab886c37c502e2f29.jpg, createdBy=6bb22051299, createdName=微笑人参, createdTime=Thu Jun 15 22:46:51 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211173, encodeId=e3572111e393, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Jun 15 17:36:47 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210883, encodeId=0c032108832a, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu Jun 15 06:24:14 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210697, encodeId=96c221069ef7, content=ppi种类多,都OK吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Wed Jun 14 15:49:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210691, encodeId=742521069154, content=是否会导致质子泵抑制剂过多应用呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Ne59unJiaEKVBVsw2H5iaLnmLt108lIrJ6YTqVphNiao7iaUJuuRE3xickhLErmQ99C3vF1zsf7DKXibuAQLOMjy7cgqj/0, createdBy=a8102049538, createdName=Medsci0421, createdTime=Wed Jun 14 14:59:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 Medsci0421

    是否会导致质子泵抑制剂过多应用呢?

    0

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