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NEJM:降脂降压多药合一,才是心血管疾病药物更佳的选择!

2020-11-17 MedSci原创 MedSci原创

对于心血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出。2019年,《柳叶刀》和《新英格兰医学杂志》分别发表

对于血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出。2019年,《柳叶刀》和《新英格兰医学杂志》分别发表PolyIran研究和美国南方社区队列研究的结果,支持复方药物能有效预防相当一部分心血管事件,相比单一药物,复方药物更具有优势(详细见:Lancet:多组分复发制剂用于中低收入国家心血管疾病预防)。

最新一项研究结果,来自于中低收入国家的无心血管疾病(CVD)的中度风险人群中,再次证明复方药物可能更具有优势,研究结果发表在顶级期刊《新英格兰医学杂志》NEJM上。复方药物联合阿司匹林,可以将这些患者的心血管疾病风险降低达到31%。

 

来源:New England Journal of Medicine

这项研究名为TIPS-3,该研究在尚未患心血管疾病但由于高血压、糖尿病或其他基础疾病而属于中等风险的人群中开展。TIPS-3主要在中等收入国家进行,但它具有全球意义。

研究共纳入了5713多名患者,来自印度、菲律宾、哥伦比亚、加拿大等多个国家。受试者中,年龄在50岁以下的男性,年龄在55岁以下且具有INTERHEART风险评分(IHRS)或10以上的女性,或者年龄在65岁或以上的IHRS 5以上的男性和女性。超过80%的人有高血压病史或血压升高史,约三分之一的人患有糖尿病或血糖升高。

研究采用了2×2×2析因设计,患者随机分组,接受复方药物“Polycap”(含有40mg辛伐他汀、100mg阿替洛尔、25mg氢氯噻嗪和10mg雷米普利)或安慰剂(每日);阿司匹林(75mg)或安慰剂(每日);维生素D或安慰剂(每月)。此次发表的结果主要针对复方药物和阿司匹林及其组合的对比,尚未包含对维生素D的分析。主要结局为对心血管事件的影响,包括心血管原因死亡、心梗、卒中、心脏骤停、心力衰竭或血运重建。

对于主要的复合终点,在平均随访4.6年后,与安慰剂相比,使用复方药物治疗的患者的心血管死亡,心梗,卒中,心力衰竭,心脏骤停和血运重建相对危险度降低了21%(HR = 0.79; 95%CI,0.63-1.00; P = 0.05 )。同样,与安慰剂相比,单独使用阿司匹林可使心血管死亡,心梗或卒中减少14%(HR 0.86,95%CI 0.67-1.10)。 敏感性分析后,这一发现没有变化(HR 0.83,95%CI 0.62-1.10)。仅服用阿司匹林并未显著改变心血管事件风险;而阿司匹林联用复方药物表现出了明显的预防价值,低密度脂蛋白胆固醇(LDL-C)水平降低约19 mg /dL,收缩压降低约5.8 mm Hg,心血管事件风险显著降低31%。

与双重安慰剂相比,将阿司匹林添加到复方药物中的CVD风险更低(4.1%vs 5.8%,HR 0.69,95%CI 0.50-0.97)。敏感性测试后结果看起来更好(HR 0.61,95%CI 0.41-0.91)。

整体各组安全性非常好。与安慰剂相比,复方药物严重不良事件的发生率略低。约1.5%的复方药物服用者出现头晕或低血压现象,但研究人员可以改用更低剂量来控制不良反应。其他不良反应,例如头晕或高血压(2.7%vs. 1.1%)或咳嗽(1.1%vs. 0.6%),复方药物治疗较高,但停药后可逆转。大出血或小出血或胃肠道出血无差异。研究团队推测,可能有两个因素起到了作用:(1)试验排除了有出血史或胃肠道症状的人,(2)阿司匹林的剂量比其他一级预防试验中采用的剂量更低。

整体研究依从性良好。依普利普和安慰剂组的依从性差异在BP药物治疗中为80%,在他汀类药物治疗中为82%。 2年时的不依从率为19%,4年时的不依从率为32%。在1.5年中,由于药品供应问题,依从性大幅下降。

在研究结束时,仅5%的停药是由于副作用。其他患者出现依从性问题主要是由于复方药物生产和配送延迟,以及试验后期新冠疫情的影响。在没有因非医学原因而停药的受试者中进行敏感性分析显示,复方药物联用阿司匹林的益处更明显,心血管事件风险降低39%,这可能更准确反映了这一组合疗法的实际获益。

Salim Yusuf博士说,这种复方药物对危险因素影响不大。最初,血压(BP)下降了约10毫米,但随着时间的流逝,血压下降了。 Salim Yusuf博士说:“这不能用依从性下降来解释。” “我认为人体刚刚适应了血压降低的作用,并且存在补偿机制。” LDL降低低于预期。平均差异为19 mg / dL(P <.0001),仅为研究人员预期的一半。

该研究中的复方药物含有阿替洛尔100毫克,雷米普利10毫克,氢氯噻嗪25毫克和辛伐他汀40毫克。 据Yusuf称,每天一次的胶囊“成本中性”,在印度每天仅要花费33美分。

研究通讯作者Salim Yusuf博士指出,“这种复方药物的策略适用于所有国家,而不仅仅是低收入地区。如果全球有一半合适的患者服用这类复方药物,每年将避免300万-500万心血管事件。”

Yusuf博士说:“使用复方药物的策略可使心血管事件相对减少约30%至40%。低于研究者最初的假设,并指出研究行为面临诸多挑战” “鉴于CVD是世界上的普遍情况,因此在全球范围内非常重要。”

AHA心脏病预防小组负责人、华盛顿大学(University of Washington)心脏病专家,Eugene Yang博士点评认为“这项研究非常重要”,而且这是“迄今为止,我们掌握的最好的数据”。

Yusuf在AHA新闻发布会上说:“这有望证明阿司匹林比其他治疗方法更有益。” “精心选择的阿司匹林确实在一级预防,生活方式管理和使用其余多药成分中起作用。” 值得注意的是,阿司匹林已经在心脏病CVD一级预防指南2019年AHA和美国大学的ASCEND后降级,ARRIVE试验表明老年人的净效益和那些患有糖尿病。

Yusuf建议,阿司匹林在ASCEND和ARRIVE中的CVD益处已被出血率所抵消,后者在TIPS-3中较低,这可能是由于磨合期和阿司匹林剂量低(每天75 mg)引起的。 根据澳大利亚悉尼乔治全球健康研究所MBBS,SM,PhD的会议讨论者Anushka Patel的说法,总的来说,固定剂量联合疗法的益处在包括HOPE-3和PolyIran在内的所有试验中都是一致的。

Anushka Patel评论说,TIPS-3主要在中等收入国家进行,但它具有全球意义。 Donald Lloyd-Jones说:“今天眼前发生了范式转变,”芝加哥西北大学芬伯格医学院的Donald Lloyd-Jones博士说。他同意复方药物的方法适用于全球范围,但仍对低资源环境特别有吸引力。

Yusuf强调说,复方药物疗法在富国和穷国均可受益。 “为什么有钱人不会从容易采取的措施中受益,并且可以将风险降低30%到40%?”他问道,他说“这是给穷人的”的“神话”没有根据。

不过本研究也受到很多挑战,患者招募时间从5年改为2年,而印度则面临监管方面的挑战,而该研究方案甚至在中国,巴西和阿根廷都没有得到批准。

原始出处:

Salim Yusuf, et al., (2020). Polypill with or without Aspirin in Persons without Cardiovascular Disease. N Engl J Med, DOI: 10.1056/NEJMoa2028220

Yusuf S, et al. Aspirin Alone and in Combination With a Polypill in Cardiovascular Disease Primary Prevention: Results From the International Polycap Study (TIPS)-3. LBS.02, Late-Breaking Clinical Science Virtual AHA Scientific Sessions 2020, 13-17 Nov.

Polypill, Aspirin Together Make a Difference in Large Outcomes Trial — Aspirin proves mettle in primary prevention, TIPS-3 trial shows。 https://www.medpagetoday.com/meetingcoverage/aha/89665

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    2020-11-17 Hangman

    评论得积分

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    2020-11-23 147aac8dm89暂无昵称

    来喽

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=899913, encodeId=11fb89991366, content=评论得积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201030/42cd5653f1304c9ba6070e588265b72d/e52b07d53dff40b1a0cf9dfe3218b3a8.jpg, createdBy=64735429102, createdName=Hangman, createdTime=Tue Nov 17 16:36:06 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901457, encodeId=0fc990145ef4, content=来喽, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=98035234857, createdName=147aac8dm89暂无昵称, createdTime=Mon Nov 23 14:57:29 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292090, encodeId=6bce129209017, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498792, encodeId=62f71498e9242, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900223, encodeId=676590022344, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94325436138, createdName=ms7000000146277906, createdTime=Wed Nov 18 16:27:59 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900252, encodeId=06a8900252ce, content=国内企业还是没有眼光,不知道从研究切入!这类复方,国内很多企业都在生产, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Nov 18 18:22:53 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900235, encodeId=63b5900235dd, content=希望国内药企抓住机遇,开发出价廉效佳的复合制剂。肯定会受到市场欢迎!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Wed Nov 18 17:19:50 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900112, encodeId=13f1900112cd, content=对于心血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Wed Nov 18 10:10:26 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900074, encodeId=d39d9000e4df, content=文章不错啊!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=61022504273, createdName=124a6bfdm47暂无昵称, createdTime=Wed Nov 18 08:40:41 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899946, encodeId=38e78999463d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82a05148997, createdName=14691211m03(暂无昵称), createdTime=Tue Nov 17 18:11:27 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=899913, encodeId=11fb89991366, content=评论得积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201030/42cd5653f1304c9ba6070e588265b72d/e52b07d53dff40b1a0cf9dfe3218b3a8.jpg, createdBy=64735429102, createdName=Hangman, createdTime=Tue Nov 17 16:36:06 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901457, encodeId=0fc990145ef4, content=来喽, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=98035234857, createdName=147aac8dm89暂无昵称, createdTime=Mon Nov 23 14:57:29 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292090, encodeId=6bce129209017, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498792, encodeId=62f71498e9242, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900223, encodeId=676590022344, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94325436138, createdName=ms7000000146277906, createdTime=Wed Nov 18 16:27:59 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900252, encodeId=06a8900252ce, content=国内企业还是没有眼光,不知道从研究切入!这类复方,国内很多企业都在生产, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Nov 18 18:22:53 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900235, encodeId=63b5900235dd, content=希望国内药企抓住机遇,开发出价廉效佳的复合制剂。肯定会受到市场欢迎!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Wed Nov 18 17:19:50 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900112, encodeId=13f1900112cd, content=对于心血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Wed Nov 18 10:10:26 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900074, encodeId=d39d9000e4df, content=文章不错啊!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=61022504273, createdName=124a6bfdm47暂无昵称, createdTime=Wed Nov 18 08:40:41 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899946, encodeId=38e78999463d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82a05148997, createdName=14691211m03(暂无昵称), createdTime=Tue Nov 17 18:11:27 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-18 ms7000000146277906

    学习

    0

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    2020-11-18 lovetcm

    国内企业还是没有眼光,不知道从研究切入!这类复方,国内很多企业都在生产

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=899913, encodeId=11fb89991366, content=评论得积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201030/42cd5653f1304c9ba6070e588265b72d/e52b07d53dff40b1a0cf9dfe3218b3a8.jpg, createdBy=64735429102, createdName=Hangman, createdTime=Tue Nov 17 16:36:06 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901457, encodeId=0fc990145ef4, content=来喽, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=98035234857, createdName=147aac8dm89暂无昵称, createdTime=Mon Nov 23 14:57:29 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292090, encodeId=6bce129209017, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498792, encodeId=62f71498e9242, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900223, encodeId=676590022344, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94325436138, createdName=ms7000000146277906, createdTime=Wed Nov 18 16:27:59 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900252, encodeId=06a8900252ce, content=国内企业还是没有眼光,不知道从研究切入!这类复方,国内很多企业都在生产, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Nov 18 18:22:53 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900235, encodeId=63b5900235dd, content=希望国内药企抓住机遇,开发出价廉效佳的复合制剂。肯定会受到市场欢迎!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Wed Nov 18 17:19:50 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900112, encodeId=13f1900112cd, content=对于心血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Wed Nov 18 10:10:26 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900074, encodeId=d39d9000e4df, content=文章不错啊!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=61022504273, createdName=124a6bfdm47暂无昵称, createdTime=Wed Nov 18 08:40:41 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899946, encodeId=38e78999463d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82a05148997, createdName=14691211m03(暂无昵称), createdTime=Tue Nov 17 18:11:27 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-18 weigq

    希望国内药企抓住机遇,开发出价廉效佳的复合制剂。肯定会受到市场欢迎!

    1

    展开1条回复
  8. [GetPortalCommentsPageByObjectIdResponse(id=899913, encodeId=11fb89991366, content=评论得积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201030/42cd5653f1304c9ba6070e588265b72d/e52b07d53dff40b1a0cf9dfe3218b3a8.jpg, createdBy=64735429102, createdName=Hangman, createdTime=Tue Nov 17 16:36:06 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901457, encodeId=0fc990145ef4, content=来喽, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=98035234857, createdName=147aac8dm89暂无昵称, createdTime=Mon Nov 23 14:57:29 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292090, encodeId=6bce129209017, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498792, encodeId=62f71498e9242, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900223, encodeId=676590022344, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94325436138, createdName=ms7000000146277906, createdTime=Wed Nov 18 16:27:59 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900252, encodeId=06a8900252ce, content=国内企业还是没有眼光,不知道从研究切入!这类复方,国内很多企业都在生产, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Nov 18 18:22:53 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900235, encodeId=63b5900235dd, content=希望国内药企抓住机遇,开发出价廉效佳的复合制剂。肯定会受到市场欢迎!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Wed Nov 18 17:19:50 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900112, encodeId=13f1900112cd, content=对于心血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Wed Nov 18 10:10:26 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900074, encodeId=d39d9000e4df, content=文章不错啊!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=61022504273, createdName=124a6bfdm47暂无昵称, createdTime=Wed Nov 18 08:40:41 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899946, encodeId=38e78999463d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82a05148997, createdName=14691211m03(暂无昵称), createdTime=Tue Nov 17 18:11:27 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-18 咻凡

    对于心血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出

    0

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    2020-11-18 124a6bfdm47暂无昵称

    文章不错啊!

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=899913, encodeId=11fb89991366, content=评论得积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201030/42cd5653f1304c9ba6070e588265b72d/e52b07d53dff40b1a0cf9dfe3218b3a8.jpg, createdBy=64735429102, createdName=Hangman, createdTime=Tue Nov 17 16:36:06 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901457, encodeId=0fc990145ef4, content=来喽, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=98035234857, createdName=147aac8dm89暂无昵称, createdTime=Mon Nov 23 14:57:29 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292090, encodeId=6bce129209017, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498792, encodeId=62f71498e9242, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Nov 19 05:08:35 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900223, encodeId=676590022344, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94325436138, createdName=ms7000000146277906, createdTime=Wed Nov 18 16:27:59 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900252, encodeId=06a8900252ce, content=国内企业还是没有眼光,不知道从研究切入!这类复方,国内很多企业都在生产, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Nov 18 18:22:53 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900235, encodeId=63b5900235dd, content=希望国内药企抓住机遇,开发出价廉效佳的复合制剂。肯定会受到市场欢迎!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Wed Nov 18 17:19:50 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900112, encodeId=13f1900112cd, content=对于心血管疾病高危人群,不少患者需要同时关注血压、血脂等多个指标。近年来,含有多种药物成分的“复方”心血管药物的概念被提出, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Wed Nov 18 10:10:26 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900074, encodeId=d39d9000e4df, content=文章不错啊!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=61022504273, createdName=124a6bfdm47暂无昵称, createdTime=Wed Nov 18 08:40:41 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899946, encodeId=38e78999463d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82a05148997, createdName=14691211m03(暂无昵称), createdTime=Tue Nov 17 18:11:27 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-17 14691211m03(暂无昵称)

    学习

    0

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JAHA:乳腺癌患者心脏毒性和心血管生物标志物

NT-proBNP和血红蛋白与接受剂量强化化疗的早期乳腺癌患者的心脏毒性反应显著相关,而高敏心脏肌钙蛋白T则不然。

中国糖尿病患者一定要警惕这种心血管疾病!患病率远超全球!

“在中国,33.9%的2型糖尿病患者患有心血管疾病。其中,94.9%患有动脉粥样硬化性心血管疾病,这一比例远高于全球水平”。在11月6日第三届中国国际进口博览会上,全球糖尿病治

痛惜!“当代心脏病学之父”陈灏珠院士今晨逝世,享年96岁

今天凌晨3点09分,中国工程院院士、“当代心脏病学之父”陈灏珠院士逝世,享年96岁。

Clinical Nutrition: 地中海饮食减少了心血管高风险的患者动脉粥样硬化的形成

循环微囊泡(cMV)是富含磷脂的小囊泡,有助于动脉粥样硬化形成过程,是心血管疾病(CVD)负担和进展的生物标志物。饮食是预防CVD的基石,但饮食对cMV脱落的影响的特征尚不明确。

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