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NEJM:妊娠期高血压疾病:尴尬的舒张压要不要控制?!

2015-02-04 Mechront 译 MedSci原创

关于妊娠期高血压疾病是产科常见疾患,患病率约为10%。1%在怀孕前就存在高血压,即妊娠合并慢性高血压;5% - 6%有不伴蛋白尿的妊娠期高血压;2%为子痫前期。先前有研究表明妊娠合并慢性高血压和34周前妊娠期高血压会增加围生期并发症和孕产妇并发症风险。 目前临床上对于妊娠期伴有轻度高血压孕产妇血压管理目标仍有争议。因此Laura A. Magee等人进行了一项开放的、国际的、多中心的随机对照

关于妊娠期高血压疾病是产科常见疾患,患病率约为10%。1%在怀孕前就存在高血压,即妊娠合并慢性高血压;5% - 6%有不伴蛋白尿的妊娠期高血压;2%为子痫前期。先前有研究表明妊娠合并慢性高血压和34周前妊娠期高血压会增加围生期并发症和孕产妇并发症风险。

目前临床上对于妊娠期伴有轻度高血压孕产妇血压管理目标仍有争议。因此Laura A. Magee等人进行了一项开放的、国际的、多中心的随机对照试验,观察血压控制情况与母婴结局的联系。

该研究纳入标准:1、孕周 14w≤孕周<37。2、有不伴蛋白尿的轻度高血压(孕前或孕20周前舒张压高于90mmHg)或妊娠期高血压。3、若未服用降压药,舒张压:90-105mmHg;若在服用降压药,则标准为85-105mmHg。4、宫内单活胎。排除了收缩压高于160mmHg、蛋白尿、孕14周或之后服用ACE、存在其他影响研究的基础疾病和胎儿有结构畸形或染色体异常等孕妇。

研究观察了流产等胎儿丢失和新生儿期(出生后28天)超过48小时的新生儿高级护理作为初期结果。同时记录了孕妇严重的妊娠期并发症直至产后6周或者孕妇住院管理作为次要终点。最新研究结果发表在2015-01-29 NEJM。

研究共纳入987名孕妇,其中74.6%为先前存在高血压,随机分为两组。非严格控制血压组:以舒张压在100mmHg为目标;严格控制血压组:以舒张压在85mmHg为目标。两组初期观察结果(胎儿丢失或新生儿高级护理)发生率:非严格组 31.4%;严格组 30.7%;差别无统计学意义:OR  1.02,95% CI  0.77-1.35。妊娠期严重并发症两组发生率分别为:非严格组 3.7%;严格组 2.0%;差别无统计学意义:OR  1.74,95% CI  0.79-3.84;尽管平均舒张压非严格组比严格组高出4.6mmHg:95% CI  3.7-5.4。在非严格组有40.6%的孕妇发展为中度或重度高血压(≥16./110 mmHg),而严格组为27.5%,两组比较:P<0.001。



Figure 2. Blood-Pressure Values among Women with Severe Hypertension.
Panel A shows the percentage of women with systolic blood pressure of 160 mm Hg or higher, and Panel B shows the percentage of women with diastolic blood pressure of 110 mm Hg or higher. I bars represent 95% confidence intervals.

该研究结果表示两种管理方式在胎儿丢失、高级新生儿护理和孕产妇并发症在统计学上差别无意义,但是非严格组有更高的频率患中度或重度高血压。

原始出处:

Magee LA1, von Dadelszen P, Rey E, Ross S, Asztalos E, Murphy KE, Menzies J, Sanchez J, Singer J, Gafni A, Gruslin A, Helewa M, Hutton E, Lee SK, Lee T, Logan AG, Ganzevoort W, Welch R, Thornton JG, Moutquin JM.Less-tight versus tight control of hypertension in pregnancy.N Engl J Med. 2015 Jan 29;372(5):407-17. doi: 10.1056/NEJMoa1404595.

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    2016-01-27 doctording1

    值得临床关注

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=60683, encodeId=34b660683eb, content=值得临床关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60682, encodeId=609e6068294, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=212, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60681, encodeId=a69460681b8, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60680, encodeId=1daf60680cc, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693018, encodeId=4b161693018a3, content=<a href='/topic/show?id=655a4e32160' target=_blank style='color:#2F92EE;'>#尴尬#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47321, encryptionId=655a4e32160, topicName=尴尬)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b6529322635, createdName=yilong5287552, createdTime=Thu Dec 24 18:57:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16190, encodeId=e6bd16190dd, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=227, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=da6b7222, createdName=chinayinhan, createdTime=Tue Feb 17 00:53:00 CST 2015, time=2015-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15940, encodeId=43a5159401d, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:51:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15465, encodeId=f6ff154653c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 15 13:48:00 CST 2015, time=2015-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250944, encodeId=5b9e1250944ad, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323086, encodeId=6fc213230866a, content=<a href='/topic/show?id=80ca865895e' target=_blank style='color:#2F92EE;'>#舒张压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86589, encryptionId=80ca865895e, topicName=舒张压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2016-01-27 doctording1

    是一篇不错的文章

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=60683, encodeId=34b660683eb, content=值得临床关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60682, encodeId=609e6068294, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=212, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60681, encodeId=a69460681b8, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60680, encodeId=1daf60680cc, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693018, encodeId=4b161693018a3, content=<a href='/topic/show?id=655a4e32160' target=_blank style='color:#2F92EE;'>#尴尬#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47321, encryptionId=655a4e32160, topicName=尴尬)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b6529322635, createdName=yilong5287552, createdTime=Thu Dec 24 18:57:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16190, encodeId=e6bd16190dd, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=227, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=da6b7222, createdName=chinayinhan, createdTime=Tue Feb 17 00:53:00 CST 2015, time=2015-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15940, encodeId=43a5159401d, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:51:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15465, encodeId=f6ff154653c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 15 13:48:00 CST 2015, time=2015-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250944, encodeId=5b9e1250944ad, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323086, encodeId=6fc213230866a, content=<a href='/topic/show?id=80ca865895e' target=_blank style='color:#2F92EE;'>#舒张压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86589, encryptionId=80ca865895e, topicName=舒张压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2016-01-27 doctording1

    这篇文章有一定深度

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=60683, encodeId=34b660683eb, content=值得临床关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60682, encodeId=609e6068294, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=212, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60681, encodeId=a69460681b8, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60680, encodeId=1daf60680cc, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693018, encodeId=4b161693018a3, content=<a href='/topic/show?id=655a4e32160' target=_blank style='color:#2F92EE;'>#尴尬#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47321, encryptionId=655a4e32160, topicName=尴尬)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b6529322635, createdName=yilong5287552, createdTime=Thu Dec 24 18:57:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16190, encodeId=e6bd16190dd, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=227, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=da6b7222, createdName=chinayinhan, createdTime=Tue Feb 17 00:53:00 CST 2015, time=2015-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15940, encodeId=43a5159401d, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:51:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15465, encodeId=f6ff154653c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 15 13:48:00 CST 2015, time=2015-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250944, encodeId=5b9e1250944ad, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323086, encodeId=6fc213230866a, content=<a href='/topic/show?id=80ca865895e' target=_blank style='color:#2F92EE;'>#舒张压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86589, encryptionId=80ca865895e, topicName=舒张压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2016-01-27 doctording1

    不错,赞一个

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=60683, encodeId=34b660683eb, content=值得临床关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60682, encodeId=609e6068294, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=212, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60681, encodeId=a69460681b8, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60680, encodeId=1daf60680cc, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:41:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693018, encodeId=4b161693018a3, content=<a href='/topic/show?id=655a4e32160' target=_blank style='color:#2F92EE;'>#尴尬#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47321, encryptionId=655a4e32160, topicName=尴尬)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b6529322635, createdName=yilong5287552, createdTime=Thu Dec 24 18:57:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16190, encodeId=e6bd16190dd, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=227, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=da6b7222, createdName=chinayinhan, createdTime=Tue Feb 17 00:53:00 CST 2015, time=2015-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15940, encodeId=43a5159401d, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:51:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15465, encodeId=f6ff154653c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 15 13:48:00 CST 2015, time=2015-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250944, encodeId=5b9e1250944ad, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323086, encodeId=6fc213230866a, content=<a href='/topic/show?id=80ca865895e' target=_blank style='color:#2F92EE;'>#舒张压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86589, encryptionId=80ca865895e, topicName=舒张压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Feb 06 04:57:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2015-02-17 chinayinhan

    已阅

    0

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    2015-02-16 windmilL1989

    已阅

    0

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    2015-02-15 午夜星河

    明白了

    0

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