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JAMA Surgery:肾移植受者早期皮质类固醇戒断与长期皮质类固醇治疗对于疾病预后的影响

2021-03-31 MedSci原创 MedSci原创

肾移植患者需要进行终生的免疫抑制药物的治疗,以防止排斥反应的发生。最常见的免疫抑制的药物分为3类,分别为钙调神经磷酸酶抑制剂(环孢素或他克莫司),麦考酚酸或硫唑嘌呤和皮质类固醇。

      肾移植患者需要进行终生的免疫抑制药物的治疗,以防止排斥反应的发生。最常见的免疫抑制的药物分为3类,分别为钙调神经磷酸酶抑制剂(环孢素或他克莫司),麦考酚酸或硫唑嘌呤,皮质类固醇(泼尼松)。有研究显示皮质类固醇的戒断与短期排斥和晚期同种异体移植失败的风险增加相关,但是长期使用皮质类固醇激素会导致一系列的并发症的出现。因此,本项研究旨在探究随机选择继续或停用皮质类固醇激素治疗的患者的长期肾脏移植结果。

      本项前瞻性多中心随机双盲对照试验于1999年11月开始,持续到了2002年12月。该研究总共包括了美国28个肾脏移植中心。研究人员将386名接受过肾脏移植的低至中度免疫风险成人肾移植患者纳入本项研究,所有患者移植后第一周均未发生移植物功能延迟或短期排斥的出现。所有患者在移植后的第7天随机接受他克莫司和麦考酚酸的治疗同时随机接受皮质类固醇激素治疗。肾脏同种异体移植失败的定义为患者死亡或同种异体移植失败需要长期透析。

      研究结果显示在386例患者中,有191例患者停止了皮质类固醇激素治疗(平均年龄为46.5 岁),而194例患者为长期接受皮质激素治疗患者(平均年龄46.3 岁)。移植后的中位(四分位间距)随访时间为15.8(12.0-16.3)年。包括死亡在内的任何原因造成的同种异体移植失败的调整后风险比为0.83(95%CI,0.62-1.10; P = .19),退出皮质类固醇激素治疗的患者与继续服用皮质类固醇激素治疗的患者之间没有差异。

图:使用皮质类固醇激素与否的长期随访生存曲线

      本项研究证实对于低至中度免疫风险的肾移植患者,长期服用糖皮质激素可能不需要作为基于钙调神经磷酸酶的多种药物免疫抑制方案的一部分,停用糖皮质激素可能利大于弊。

 

 

 

原始出处:

E. Steve Woodle. Et al. Early Corticosteroid Cessation vs Long-term Corticosteroid Therapy in Kidney Transplant Recipients Long-term Outcomes of a Randomized Clinical Trial. JAMA SURGERY.2021.

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    2021-05-28 chg121
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beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953125, encodeId=94479531250b, content=点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:54 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952989, encodeId=b83995298995, content=非常有收获, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f52c5469297, createdName=ms2000002125328257, createdTime=Thu Apr 01 07:54:41 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036550, encodeId=8fab1036550af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 01 02:00:33 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952957, encodeId=971595295e38, content=学习赚积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00f95475617, createdName=ms4000001895179476, createdTime=Wed Mar 31 23:15:07 CST 2021, time=2021-03-31, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1877753, encodeId=e13618e775366, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri May 28 03:00:33 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021702, encodeId=f3122021e0248, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Fri Nov 19 21:00:33 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739332, encodeId=b5041e393327f, content=<a href='/topic/show?id=908be07412a' target=_blank style='color:#2F92EE;'>#疾病预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70741, encryptionId=908be07412a, topicName=疾病预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b25634523578, createdName=ms2694732865965676, createdTime=Tue Oct 26 06:00:33 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313465, encodeId=2fe313134654b, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559881, encodeId=48e3155988162, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565890, encodeId=d7981565890fc, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953125, encodeId=94479531250b, content=点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:54 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952989, encodeId=b83995298995, content=非常有收获, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f52c5469297, createdName=ms2000002125328257, createdTime=Thu Apr 01 07:54:41 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036550, encodeId=8fab1036550af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 01 02:00:33 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952957, encodeId=971595295e38, content=学习赚积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00f95475617, createdName=ms4000001895179476, createdTime=Wed Mar 31 23:15:07 CST 2021, time=2021-03-31, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1877753, encodeId=e13618e775366, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri May 28 03:00:33 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021702, encodeId=f3122021e0248, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, 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topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559881, encodeId=48e3155988162, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565890, encodeId=d7981565890fc, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953125, encodeId=94479531250b, content=点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:54 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952989, encodeId=b83995298995, content=非常有收获, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f52c5469297, createdName=ms2000002125328257, createdTime=Thu Apr 01 07:54:41 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036550, encodeId=8fab1036550af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 01 02:00:33 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952957, encodeId=971595295e38, content=学习赚积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00f95475617, createdName=ms4000001895179476, createdTime=Wed Mar 31 23:15:07 CST 2021, time=2021-03-31, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1877753, encodeId=e13618e775366, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri May 28 03:00:33 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021702, encodeId=f3122021e0248, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Fri Nov 19 21:00:33 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739332, encodeId=b5041e393327f, content=<a href='/topic/show?id=908be07412a' target=_blank style='color:#2F92EE;'>#疾病预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70741, encryptionId=908be07412a, topicName=疾病预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b25634523578, createdName=ms2694732865965676, createdTime=Tue Oct 26 06:00:33 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313465, encodeId=2fe313134654b, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559881, encodeId=48e3155988162, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565890, encodeId=d7981565890fc, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953125, encodeId=94479531250b, content=点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:54 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952989, encodeId=b83995298995, content=非常有收获, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f52c5469297, createdName=ms2000002125328257, createdTime=Thu Apr 01 07:54:41 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036550, encodeId=8fab1036550af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 01 02:00:33 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952957, encodeId=971595295e38, content=学习赚积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00f95475617, createdName=ms4000001895179476, createdTime=Wed Mar 31 23:15:07 CST 2021, time=2021-03-31, status=1, ipAttribution=)]
    2021-04-01 1881ef655dm

    点赞

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1877753, encodeId=e13618e775366, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri May 28 03:00:33 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021702, encodeId=f3122021e0248, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Fri Nov 19 21:00:33 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739332, encodeId=b5041e393327f, content=<a href='/topic/show?id=908be07412a' target=_blank style='color:#2F92EE;'>#疾病预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70741, encryptionId=908be07412a, topicName=疾病预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b25634523578, createdName=ms2694732865965676, createdTime=Tue Oct 26 06:00:33 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313465, encodeId=2fe313134654b, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559881, encodeId=48e3155988162, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565890, encodeId=d7981565890fc, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953125, encodeId=94479531250b, content=点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:54 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952989, encodeId=b83995298995, content=非常有收获, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f52c5469297, createdName=ms2000002125328257, createdTime=Thu Apr 01 07:54:41 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036550, encodeId=8fab1036550af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 01 02:00:33 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952957, encodeId=971595295e38, content=学习赚积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00f95475617, createdName=ms4000001895179476, createdTime=Wed Mar 31 23:15:07 CST 2021, time=2021-03-31, status=1, ipAttribution=)]
    2021-04-01 ms2000002125328257

    非常有收获

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1877753, encodeId=e13618e775366, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri May 28 03:00:33 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021702, encodeId=f3122021e0248, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, 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topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559881, encodeId=48e3155988162, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565890, encodeId=d7981565890fc, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953125, encodeId=94479531250b, content=点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:54 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952989, encodeId=b83995298995, content=非常有收获, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f52c5469297, createdName=ms2000002125328257, createdTime=Thu Apr 01 07:54:41 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036550, encodeId=8fab1036550af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 01 02:00:33 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952957, encodeId=971595295e38, content=学习赚积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00f95475617, createdName=ms4000001895179476, createdTime=Wed Mar 31 23:15:07 CST 2021, time=2021-03-31, status=1, ipAttribution=)]
    2021-04-01 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1877753, encodeId=e13618e775366, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri May 28 03:00:33 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021702, encodeId=f3122021e0248, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Fri Nov 19 21:00:33 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1739332, encodeId=b5041e393327f, content=<a href='/topic/show?id=908be07412a' target=_blank style='color:#2F92EE;'>#疾病预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70741, encryptionId=908be07412a, topicName=疾病预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b25634523578, createdName=ms2694732865965676, createdTime=Tue Oct 26 06:00:33 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313465, encodeId=2fe313134654b, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559881, encodeId=48e3155988162, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565890, encodeId=d7981565890fc, content=<a href='/topic/show?id=853182620c7' target=_blank style='color:#2F92EE;'>#肾移植受者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82620, encryptionId=853182620c7, topicName=肾移植受者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c4715034237, createdName=hjwang84, createdTime=Fri Apr 02 14:00:33 CST 2021, time=2021-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953125, encodeId=94479531250b, content=点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:54 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952989, encodeId=b83995298995, content=非常有收获, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f52c5469297, createdName=ms2000002125328257, createdTime=Thu Apr 01 07:54:41 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036550, encodeId=8fab1036550af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 01 02:00:33 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=952957, encodeId=971595295e38, content=学习赚积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00f95475617, createdName=ms4000001895179476, createdTime=Wed Mar 31 23:15:07 CST 2021, time=2021-03-31, status=1, ipAttribution=)]
    2021-03-31 ms4000001895179476

    学习赚积分

    0

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