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儿童哮喘:谨防过度诊断!

2016-02-29 MedSci MedSci原创

据英国《每日电讯报》报道,在荷兰进行的一项最新研究中发现约半数以上(53.5%)的儿童哮喘被过度诊断,导致不必要的治疗,疾病负担,并影响他们的生活质量。 研究内容和方法 这项研究是由Julius 医疗中心和Utrecht大学医学中心的研究人员在荷兰地区进行,该研究发表在<<英国全科医学杂志>>上。 正如研究人员所说,哮喘是儿童时期最常见的疾病之一。据报道,在

导语

据英国《每日电讯报》报道,在荷兰进行的一项最新研究中发现约半数以上(53.5%)的儿童哮喘被过度诊断,导致不必要的治疗,疾病负担,并影响他们的生活质量。

研究内容和方法

这项研究是由Julius 医疗中心和Utrecht大学医学中心的研究人员在荷兰地区进行,该研究发表在《英国全科医学杂志》上。

正如研究人员所说,哮喘是儿童时期最常见的疾病之一。据报道,在英国,每11个儿童中有1人患有哮喘。

在研究小组对652名年龄在6到17岁,曾被诊断为哮喘或长年使用吸入器的儿童(不包括那些仅在冬天使用吸入器的儿童)的医疗档案进行回顾性分析时发现,被诊断为哮喘的儿童中约半数以上(53.5%)可能没有该疾病,这意味着他们根本不需要服用哮喘药物,更不用暴露于哮喘药的副作用下。

造成儿童哮喘过度诊断的原因可能是,对6岁以上儿童,家庭医生没有进行肺功能测试,而仅依靠一个咳嗽和喘息的疾病症状进行哮喘诊断是不科学的。

研究人员发现652个被诊断患有哮喘的儿童只有16.1%进行了肺功能测试。需要重点指出的是,英国媒体的报道是准确的,但这项研究发生在荷兰,而不是英国。这些结果可能不代表英国儿童哮喘患病率的现状,但对于英国国内哮喘过度诊断现状仍具有指导意义,需要进一步适当的调查。

研究结果

652名确诊为哮喘或接收哮喘治疗的儿童中:

105例(16.1%)经肺功能测试,所以被认为是准确的诊断;

151(23.2%)有可能是哮喘,但需要肺功能测试来确定;

349(53.5%)被视为过度诊断;344例有可能是哮喘和5例经肺功能测试后排除哮喘诊断;

47(7.2%)并没有给出哮喘诊断,也不归类为过度诊断,可能他们仅开了个吸入器的处方而被纳入研究。

研究意义

英国和威尔士的卫生监督机构,意识到儿童哮喘过度诊断这个潜在的问题,并在着手审查并给出相应的指导,以提高哮喘诊断。拟定指南或草案,建议肺功能检查应作为诊断儿童和成人哮喘的首要测试。

荷兰可能存在哮喘诊断过度或不足,影响儿童长期治疗效果,是由于荷兰地区儿童的肺功能检查并不普及,因为病人必须被送到医院进行肺功能测试,这是导致哮喘诊断障碍的某个原因。在荷兰,许多家庭医生通过患儿症状和初步检查确定其哮喘病情是不严谨的,进一步的肺功能测试是需要的,如肺活量。

如果你关心你自己,或者你的孩子的哮喘情况,联系你的家庭医生。切不要未经医生同意就停止对你或者你的孩子的哮喘药物治疗,因为这可能是很危险的举措。

儿童哮喘作为呼吸道常见慢性疾病,应该得到正确诊断和个体化治疗,并在医生的指导下正确选择和使用药物,从而改善患儿生活质量或减少其不必要的治疗痛苦。

原始出处:

Looijmans-van den Akke I, van Luijn K,Verheij T. Overdiagnosis of asthma in children in primary care: a retrospective analysis. British Journal of General Practice. 2016,66(644):e152-7. doi: 10.3399/bjgp16X683965.

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    2016-03-02 忠诚向上

    注意预防

    0

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    2016-03-02 忠诚向上

    借鉴作用

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1295928, encodeId=21be129592853, content=<a href='/topic/show?id=5d41282361d' target=_blank style='color:#2F92EE;'>#儿童哮喘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28236, encryptionId=5d41282361d, topicName=儿童哮喘)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a885259, createdName=yourmama, createdTime=Wed Mar 02 08:49:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66734, encodeId=566e66e349a, content=注意预防, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66735, encodeId=3dee66e35a9, content=借鉴作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66525, encodeId=c8a766525e8, content=get新技能, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160301/IMG56D53216887587291.jpg, createdBy=3c131694128, createdName=破风4392, createdTime=Tue Mar 01 14:15:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66421, encodeId=5d0966421b7, content=还是有争论的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 09:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66410, encodeId=1b2f66410fa, content=学习一下下, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Tue Mar 01 09:09:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66405, encodeId=761166405d2, content=难题之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 08:49:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66397, encodeId=a96d6639e1d, content=应付, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef931660757, createdName=1ddeb060m96(暂无匿称), createdTime=Tue Mar 01 07:59:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66394, encodeId=839f6639493, content=过度了吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=014e108570, createdName=chenchuny, createdTime=Tue Mar 01 07:40:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66385, encodeId=24706638579, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Tue Mar 01 06:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=)]
    2016-03-01 破风4392

    get新技能

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1295928, encodeId=21be129592853, content=<a href='/topic/show?id=5d41282361d' target=_blank style='color:#2F92EE;'>#儿童哮喘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28236, encryptionId=5d41282361d, topicName=儿童哮喘)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a885259, createdName=yourmama, createdTime=Wed Mar 02 08:49:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66734, encodeId=566e66e349a, content=注意预防, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66735, encodeId=3dee66e35a9, content=借鉴作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66525, encodeId=c8a766525e8, content=get新技能, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160301/IMG56D53216887587291.jpg, createdBy=3c131694128, createdName=破风4392, createdTime=Tue Mar 01 14:15:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66421, encodeId=5d0966421b7, content=还是有争论的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 09:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66410, encodeId=1b2f66410fa, content=学习一下下, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Tue Mar 01 09:09:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66405, encodeId=761166405d2, content=难题之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 08:49:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66397, encodeId=a96d6639e1d, content=应付, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef931660757, createdName=1ddeb060m96(暂无匿称), createdTime=Tue Mar 01 07:59:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66394, encodeId=839f6639493, content=过度了吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=014e108570, createdName=chenchuny, createdTime=Tue Mar 01 07:40:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66385, encodeId=24706638579, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Tue Mar 01 06:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=)]
    2016-03-01 老段

    还是有争论的

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1295928, encodeId=21be129592853, content=<a href='/topic/show?id=5d41282361d' target=_blank style='color:#2F92EE;'>#儿童哮喘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28236, encryptionId=5d41282361d, topicName=儿童哮喘)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a885259, createdName=yourmama, createdTime=Wed Mar 02 08:49:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66734, encodeId=566e66e349a, content=注意预防, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66735, encodeId=3dee66e35a9, content=借鉴作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66525, encodeId=c8a766525e8, content=get新技能, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160301/IMG56D53216887587291.jpg, createdBy=3c131694128, createdName=破风4392, createdTime=Tue Mar 01 14:15:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66421, encodeId=5d0966421b7, content=还是有争论的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 09:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66410, encodeId=1b2f66410fa, content=学习一下下, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Tue Mar 01 09:09:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66405, encodeId=761166405d2, content=难题之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 08:49:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66397, encodeId=a96d6639e1d, content=应付, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef931660757, createdName=1ddeb060m96(暂无匿称), createdTime=Tue Mar 01 07:59:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66394, encodeId=839f6639493, content=过度了吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=014e108570, createdName=chenchuny, createdTime=Tue Mar 01 07:40:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66385, encodeId=24706638579, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Tue Mar 01 06:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=)]
    2016-03-01 tiffany8083

    学习一下下

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1295928, encodeId=21be129592853, content=<a href='/topic/show?id=5d41282361d' target=_blank style='color:#2F92EE;'>#儿童哮喘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28236, encryptionId=5d41282361d, topicName=儿童哮喘)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a885259, createdName=yourmama, createdTime=Wed Mar 02 08:49:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66734, encodeId=566e66e349a, content=注意预防, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66735, encodeId=3dee66e35a9, content=借鉴作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66525, encodeId=c8a766525e8, content=get新技能, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160301/IMG56D53216887587291.jpg, createdBy=3c131694128, createdName=破风4392, createdTime=Tue Mar 01 14:15:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66421, encodeId=5d0966421b7, content=还是有争论的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 09:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66410, encodeId=1b2f66410fa, content=学习一下下, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Tue Mar 01 09:09:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66405, encodeId=761166405d2, content=难题之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 08:49:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66397, encodeId=a96d6639e1d, content=应付, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef931660757, createdName=1ddeb060m96(暂无匿称), createdTime=Tue Mar 01 07:59:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66394, encodeId=839f6639493, content=过度了吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=014e108570, createdName=chenchuny, createdTime=Tue Mar 01 07:40:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66385, encodeId=24706638579, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Tue Mar 01 06:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=)]
    2016-03-01 老段

    难题之一

    0

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    2016-03-01 1ddeb060m96(暂无匿称)

    应付

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1295928, encodeId=21be129592853, content=<a href='/topic/show?id=5d41282361d' target=_blank style='color:#2F92EE;'>#儿童哮喘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28236, encryptionId=5d41282361d, topicName=儿童哮喘)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a885259, createdName=yourmama, createdTime=Wed Mar 02 08:49:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66734, encodeId=566e66e349a, content=注意预防, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66735, encodeId=3dee66e35a9, content=借鉴作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Mar 02 06:42:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66525, encodeId=c8a766525e8, content=get新技能, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160301/IMG56D53216887587291.jpg, createdBy=3c131694128, createdName=破风4392, createdTime=Tue Mar 01 14:15:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66421, encodeId=5d0966421b7, content=还是有争论的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 09:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66410, encodeId=1b2f66410fa, content=学习一下下, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Tue Mar 01 09:09:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66405, encodeId=761166405d2, content=难题之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Tue Mar 01 08:49:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66397, encodeId=a96d6639e1d, content=应付, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef931660757, createdName=1ddeb060m96(暂无匿称), createdTime=Tue Mar 01 07:59:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66394, encodeId=839f6639493, content=过度了吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=014e108570, createdName=chenchuny, createdTime=Tue Mar 01 07:40:00 CST 2016, time=2016-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66385, encodeId=24706638579, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Tue Mar 01 06:43:00 CST 2016, time=2016-03-01, status=1, ipAttribution=)]
    2016-03-01 chenchuny

    过度了吗

    0

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    2016-03-01 田田1746

    是的

    0

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