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林江涛:哮喘防治 砥砺前行

2018-04-26 邢辰 中华医学信息导报

4月25日,中国哮喘联盟联合中华医学会呼吸病学分会哮喘学组和全国哮喘研究协作组在北京召开“2018世界哮喘日新闻发布会”,中华医学会呼吸病学分会哮喘学组组长周新教授、殷凯生教授出席会议。中国哮喘联盟总负责人林江涛教授作主题报告《我国哮喘的控制现状及未来管理工作的挑战》。



编者按

5月1日是第二十个“世界哮喘日”,今年哮喘日的主题是“重视气道疾病防治:从现在开始(Never too early,never too late. It's always the right time to address airways disease.)”。4月25日,中国哮喘联盟联合中华医学会呼吸病学分会哮喘学组和全国哮喘研究协作组在北京召开“2018世界哮喘日新闻发布会”,中华医学会呼吸病学分会哮喘学组组长周新教授、殷凯生教授出席会议。中国哮喘联盟总负责人林江涛教授作主题报告《我国哮喘的控制现状及未来管理工作的挑战》。

控制水平及疾病认知显着提升

2015—2016年开展的全国多中心调查结果显示,我国2016年城区支气管哮喘(哮喘)总体控制率为28.5%,其中,曾参与2007—2008年哮喘控制调查的10个城市在2015—2016年调查中哮喘控制率为39.2%,较2008年(28.7%)有较大程度提高。2016年调查中哮喘发作急诊就诊率为22.3%,曾参与2007—2008年哮喘控制调查的10个城市在2015—2016年调查中这一比例为18.2%,较2008年(33.9%)明显降低。我国部分城市哮喘控制水平的提高显示出全国范围内哮喘教育和管理工作的推行对于提高哮喘控制水平的积极作用,也间接验证了推广哮喘规范化治疗的成效。但与发达国家以及指南的要求相比,我国哮喘防治依然面临巨大的挑战。

哮喘患者对疾病的认知程度与控制水平具有显着的相关性。2016年的一项结果分析显示,对疾病具有正确认知的哮喘患者的ACT评分及哮喘控制率显着高于对疾病认知不足的哮喘患者,提示哮喘患者的疾病认知水平与疾病控制水平密切相关,提高哮喘患者的认知水平是改善疾病整体控制的基石。

推广规范化治疗成效突出

哮喘的急性发作对机体产生一系列的危害,不仅造成严重的社会经济负担,也是哮喘致残和致死的重要原因。回顾性调查显示,2013—2014年间共6480例次患者因哮喘急性发作入院,占同期呼吸内科总住院人数的3.14%。与以往报道的5.6%和6.3%相比,哮喘发作住院比例明显降低。这从一个侧面反映出在全国范围内推行哮喘规范化诊治的成效,揭示了我国哮喘总体控制水平的提高。

发作住院患者病死率明显降低

危重症哮喘是导致哮喘死亡的重要原因,做好危重症哮喘的管理是降低哮喘发作病死率的关键。近年来,我国哮喘发作救治水平有了明显的提高。一项回顾性分析结果显示,哮喘急性发作住院患者病死率为0.25%,机械通气患者病死率为2.7%,显着低于国外文献报道。

识别哮喘发作的早期征兆,及时干预有助预防哮喘的发作

全国城区哮喘患者控制现状和疾病认知程度的调查(CARN-2015-01)结果显示,82.5%的哮喘患者在上次经历哮喘发作时有明确的征兆,发生频率最高的3个症状为咳嗽、胸闷、气促。哮喘发作的中位时间为2 h,平均时间90 h。因此,充分的教育哮喘患者识别哮喘发作的征兆,并在征兆出现到发作的时间窗内给予必要的干预,从而预防或减少哮喘的发作,或减轻哮喘发作的严重程度。

推广哮喘行动计划,提高患者自我管理水平

哮喘是遗传和环境两方面因素共同作用而发生和发展的疾病,通过实施有效的教育和管理,可明显减少哮喘的危险因素和诱发因素。哮喘急性发作具有一定的季节性特点,3月和9月为哮喘急性发作入院高峰月。

多数哮喘急性发作早期有征兆,82.5%的哮喘患者哮喘急性发作时存在早期征兆,发生频率最高的3个症状为咳嗽、胸闷及气促。通过识别哮喘的发作征兆,及时干预,有助于预防和减少哮喘发作。两次全国性调查对比分析结果显示,哮喘症状加重时选择使用糖皮质激素吸入剂作为缓解药物的患者比例上升了14%,提示我国近年来医师在对患者早期征兆识别、早期干预方面的教育带来了治疗观念方面明显的转变。

正确使用峰流速仪和准确记录哮喘日记是哮喘患者自我管理的重要内容之一,可有效预防和减少哮喘发作次数,对症状严重或症状不明显的患者是一种有用的监测方法,是客观判断哮喘病情最常用的手段。但2015—2016年调查中仅10.1%的患者使用过峰流速仪,曾参与2007—2008年哮喘控制调查的10个城市在2015—2016年调查中峰流速仪使用率为17.9%,稍低于2007—2008年(21.8%)数据。2016年全国城区门诊哮喘患者峰流速仪使用率较2007—2008年没有明显改善,且在未使用峰流速仪原因中,医师未介绍占65.2%,提示呼吸专科医师在患者教育中角色的缺失,今后应进一步加强呼吸专科医师的哮喘管理培训,转变观念,从而推动哮喘管理工作进一步开展。

因哮喘急性发作住院患者的疾病负担重

我国城区哮喘急性发作住院患者费用及相关情况的回顾性调查(CARN-2015-02)显示,在入院前1年之内曾因哮喘急性发作住院治疗或急诊就诊的患者中,仅28.0%的患者在入院前规律应用哮喘治疗药物,2.3%入住重症监护室,并应用机械通气。所有患者住院费用中位数为9045元,其中药品费占52.1%,辅助检查费占27.6%,治疗费占9.6%。药品费中,哮喘治疗药物费用仅占22.7%,而抗菌药物占44.0%。住院费用随着哮喘急性发作严重程度的增加而增加,入住ICU、应用机械通气、合并肺炎及入院前1年内有因哮喘急性发作住院或急诊就诊史者的平均住院费用更高。

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    2018-04-30 zb1235672

    好知识值得学习!

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    2018-04-27 一个字-牛

    学习了谢谢分享

    0

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    2018-04-26 龙胆草

    学习谢谢分享

    0

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    2018-04-26 明月清辉

    谢谢分享.学习了

    0

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    2018-04-26 1dd8c52fm63(暂无匿称)

    了解了解.继续关注

    0

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    2018-04-26 飛歌

    厉害了我的哥

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=310712, encodeId=67c6310e12ab, content=好知识值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Apr 30 12:53:58 CST 2018, time=2018-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309650, encodeId=e161309650cf, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 27 06:31:53 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309436, encodeId=efe530943600, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Apr 26 08:25:45 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309420, encodeId=240b309420b2, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Apr 26 08:01:23 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309395, encodeId=afb130939542, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Apr 26 07:39:40 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309374, encodeId=d8383093e418, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Apr 26 07:11:00 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309373, encodeId=3ab33093e370, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9572310056, createdName=12225669m29暂无昵称, createdTime=Thu Apr 26 07:09:50 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309350, encodeId=24f03093509b, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Thu Apr 26 06:43:32 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309343, encodeId=85c93093434b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Apr 26 06:26:10 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309292, encodeId=6f0330929281, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu Apr 26 05:30:08 CST 2018, time=2018-04-26, status=1, ipAttribution=)]
    2018-04-26 12225669m29暂无昵称

    学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=310712, encodeId=67c6310e12ab, content=好知识值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Apr 30 12:53:58 CST 2018, time=2018-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309650, encodeId=e161309650cf, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 27 06:31:53 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309436, encodeId=efe530943600, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Apr 26 08:25:45 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309420, encodeId=240b309420b2, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Apr 26 08:01:23 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309395, encodeId=afb130939542, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Apr 26 07:39:40 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309374, encodeId=d8383093e418, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Apr 26 07:11:00 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309373, encodeId=3ab33093e370, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9572310056, createdName=12225669m29暂无昵称, createdTime=Thu Apr 26 07:09:50 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309350, encodeId=24f03093509b, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Thu Apr 26 06:43:32 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309343, encodeId=85c93093434b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Apr 26 06:26:10 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309292, encodeId=6f0330929281, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu Apr 26 05:30:08 CST 2018, time=2018-04-26, status=1, ipAttribution=)]
    2018-04-26 易水河

    学习学习再学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=310712, encodeId=67c6310e12ab, content=好知识值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Apr 30 12:53:58 CST 2018, time=2018-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309650, encodeId=e161309650cf, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 27 06:31:53 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309436, encodeId=efe530943600, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Apr 26 08:25:45 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309420, encodeId=240b309420b2, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Apr 26 08:01:23 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309395, encodeId=afb130939542, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Apr 26 07:39:40 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309374, encodeId=d8383093e418, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Apr 26 07:11:00 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309373, encodeId=3ab33093e370, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9572310056, createdName=12225669m29暂无昵称, createdTime=Thu Apr 26 07:09:50 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309350, encodeId=24f03093509b, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Thu Apr 26 06:43:32 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309343, encodeId=85c93093434b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Apr 26 06:26:10 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309292, encodeId=6f0330929281, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu Apr 26 05:30:08 CST 2018, time=2018-04-26, status=1, ipAttribution=)]
  10. [GetPortalCommentsPageByObjectIdResponse(id=310712, encodeId=67c6310e12ab, content=好知识值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Apr 30 12:53:58 CST 2018, time=2018-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309650, encodeId=e161309650cf, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Apr 27 06:31:53 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309436, encodeId=efe530943600, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Apr 26 08:25:45 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309420, encodeId=240b309420b2, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Apr 26 08:01:23 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309395, encodeId=afb130939542, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Apr 26 07:39:40 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309374, encodeId=d8383093e418, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Apr 26 07:11:00 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309373, encodeId=3ab33093e370, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9572310056, createdName=12225669m29暂无昵称, createdTime=Thu Apr 26 07:09:50 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309350, encodeId=24f03093509b, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Thu Apr 26 06:43:32 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309343, encodeId=85c93093434b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Thu Apr 26 06:26:10 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309292, encodeId=6f0330929281, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu Apr 26 05:30:08 CST 2018, time=2018-04-26, status=1, ipAttribution=)]
    2018-04-26 秀红

    学习了

    0

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