牛俊奇:从2012 新版APASL威廉亚洲博彩公司 看替比夫定的临床应用

2012-03-04 MedSci MedSci原创

吉林大学第一医院感染症科  牛俊奇 2012年2月18日,在台湾举行的第22届亚太肝病学会(APASL)年会上公布了新版《亚太慢性乙型肝炎治疗威廉亚洲博彩公司 》(以下简称新版APASL威廉亚洲博彩公司 ),该威廉亚洲博彩公司 是在2008年版威廉亚洲博彩公司 的基础上进行修订的。这是今年肝病治疗领域中的重要事件。该威廉亚洲博彩公司 的更新标志着人们对于慢性乙型肝炎(CHB)的认识又进入一个新的阶段。在这4年中,CHB领域的研究发展迅速,所以威廉亚洲博彩公司 对流行病

吉林大学第一医院感染症科  牛俊奇

24.JPG2012218日,在台湾举行的第22届亚太肝病学会(APASL)年会上公布了新版《亚太慢性乙型肝炎治疗威廉亚洲博彩公司 》(以下简称新版APASL威廉亚洲博彩公司 ),该威廉亚洲博彩公司 是在2008年版威廉亚洲博彩公司 的基础上进行修订的。这是今年肝病治疗领域中的重要事件。该威廉亚洲博彩公司 的更新标志着人们对于慢性乙型肝炎(CHB)的认识又进入一个新的阶段。在这4年中,CHB领域的研究发展迅速,所以威廉亚洲博彩公司 对流行病学、免疫调节药物、核苷(酸)类似物、特殊人群治疗、核苷酸类似物应答者的停药、患者依从性与药物经济学等许多内容进行了讨论与更新,由于版面有限下面仅对威廉亚洲博彩公司 更新的部分内容结合替比夫定(LdT)的临床应用进行解读。
 
替比夫定被推荐为CHB初治患者一线用药
 
LdT具有强HBV DNA抑制、高HBeAg血清学转换及停药后持久应答率高等特点,根据基线特征及早期治疗应答来管理患者可获得更好的疗效和更低的耐药。
 
新版APASL威廉亚洲博彩公司 仍然强调,慢性乙型肝炎抗病毒治疗的主要目的是持久抑制HBV复制,从而减低病毒的感染性和致病性,减轻肝脏坏死性炎症。临床治疗的短期目标是获得初始应答,即乙型肝炎病毒e抗原(HBeAg)血清学转换和(或)HBV DNA检测不到和谷丙转氨酶(ALT)正常;最终的长期治疗目标是防止肝功能失代偿,减轻或阻止肝硬化和(或)肝细胞肝癌(HCC)的发生。新版APASL威廉亚洲博彩公司 将普通干扰素(IFNα)和聚乙二醇干扰素(PegIFNα-2a)、拉米夫定、阿德福韦、恩替卡韦、LdT和替诺福韦均推荐为患者初始治疗的一线用药,其中恩替卡韦和替诺福韦由于抗病毒作用强和耐药率低而着重推荐。同时新威廉亚洲博彩公司 进一步指出,对于患者的药物选择要同时考虑疗程、费用、启效时间和副作用等。从新版APASL威廉亚洲博彩公司 的推荐意见可以看出,CHB治疗药物的选择是一个综合考虑的过程,而不仅仅是根据一两个方面。而对于疗程和费用的主要决定因素是药物的疗效,即HBV DNA抑制和HBeAg血清学转换情况。
 
LdT是一种强效、特异抑制乙肝病毒复制的L-核苷类似物。Ⅲ期全球注册临床研究(GLOBE研究)结果显示,其抑制HBV DNA复制的效能要远优于拉米夫定和阿德福韦酯。上市后的研究亦显示,LdT的病毒抑制作用与恩替卡韦及替诺福韦相当。同时,优化治疗可进一步提高LdT的疗效,降低耐药。2303研究显示,LdT治疗24周时HBV DNA PCR<300拷贝/ml的患者,4年的病毒抑制率达88%HBeAg血清学转换率为66%。本届APASL公布的EFFORT研究76周结果也显示,对于替比夫定治疗24周,HBV DNA PCR>300拷贝/ml的患者,加用阿德福韦酯后未发生耐药。
 
同时根据基线选择适合的患者,对药物的长期疗效也至关重要。如对基线HBV DNA<9 log10拷贝/mlALT ≥2×ULNHBeAg阳性患者,经过24LdT治疗,71%的患者可达到HBV DNA<300 拷贝/ml,这部分患者经过2LdT治疗,分别有89%52%81%的患者实现了HBV DNA<300 拷贝/mlHBeAg血清学转换和ALT复常,耐药率仅1.8%。而在基线HBV DNA<7 Log10拷贝/mlHBeAg阴性受试者中,经过24LdT治疗,95%的受试者可达到HBV DNA<300拷贝/ml,这部分患者经过2LdT治疗, HBV DNA<300拷贝/mlALT复常和耐药的比率分别为91%83%2%
 
另一方面,新版APASL威廉亚洲博彩公司 对于核苷(酸)类似物治疗中的监测和耐药处理也给了明确的推荐意见。在病人治疗过程中,患者需每3个月检测一次ALTHBeAgHBV DNA。对使用阿德福韦和替诺福韦的患者要注意检测肾功能,LdT治疗中要注意有无肌力减弱的现象。对于阿德福韦酯耐药的患者可加用LdT治疗。而对于在LdT治疗期间发生耐药的患者,也可加用阿德福韦或者改用替诺福韦。
 
威廉亚洲博彩公司 推荐口服抗病毒药物的停药标准
 
患者HBV DNA检测不到及HBeAg血清学转换是获得停药的前提。选择替比夫定可使更多的患者有机会达到威廉亚洲博彩公司 推荐的停药标准。
 
口服抗病毒药物是否能停药一直是临床上争议的热点。众所周知,CHB治疗是一个相对较长的过程,但这并不意味着患者必须要接受一个漫长的疗程,甚至终身治疗。另一方面,治疗时间越长,患者的依从性越差,而依从性对药物疗效至关重要。美国学者的队列研究显示,近40%的病毒突破是由治疗依从性差引起,而与病毒耐药无关。治疗依从性的主要决定因素包括疗程和治疗费用。一项调研显示,在我国仅35.6%CHB治疗患者愿意承受3年以上的治疗。而大多数亚洲国家经济不发达,又是HBV感染的流行地区。所以在药物的选择上,对疗程和药物经济学要给予充分考虑。
 
新版APASL威廉亚洲博彩公司 建议,对HBeAg阳性患者,当证实至少持续12个月出现HBeAg血清学转换伴HBV DNA检测不到,可考虑停药。对HBeAg阴性患者,治疗至少持续2年,并连续3次检测不出HBV DNA且每次间隔至少6个月,可以考虑终止治疗。
 
GLOBE研究中,接受LdT治疗的39例患者依照方案规定(停药标准:治疗时间持续52周以上,HBV DNA<5 log10 拷贝/mlHBeAg阴性持续24周以上)停药,在随后的104周的访视中,80%的受试者维持HBeAg血清学转换。
 
由上可见,LdT具有强效HBV DNA抑制和高HBeAg血清学转换率及持久的停药后应答率。
 
替比夫定被推荐为阻断CHB母婴传播用药
 
替比夫定是目前中国唯一批准上市用于治疗慢乙肝的妊娠B级口服药物,其在阻断母婴传播中具有良好疗效和安全性。
 
育龄妇女与妊娠妇女如何选择抗病毒药物也是当前的热点问题。新版威廉亚洲博彩公司 对此也进行了更新。
 
新版威廉亚洲博彩公司 建议如下:对于育龄妇女,尚未妊娠者优先考虑基于干扰素的治疗,但在干扰素治疗期间不宜怀孕。妊娠需要治疗的妇女可以给予妊娠B级口服药。为了防止母婴传播,对于HBV DNA>2×106 IU/ml的妊娠妇女在妊娠晚期可以用LdT或替诺福韦治疗。
 
 
LdT是目前中国唯一批准上市用于治疗CHB的妊娠B级口服药物,中国最近的一项前瞻性开放研究也证实了其在阻断母婴传播中的疗效和安全性。该研究纳入了229HBV DNA>107拷贝/ml HBeAg阳性的妊娠妇女,其中135例从孕娠第20~32周开始给予每日LdT 600 mg治疗,对照组的94例患者不接受抗病毒治疗。治疗组中43例(33%)孕妇在分娩时达到HBV DNA检测不到(<500拷贝/ml),而对照组无人达到这一标准。在接受标准乙肝疫苗注射和乙肝免疫球蛋白注射的基础上,治疗组患者的新生儿发生围生期传播的概率为0,显著低于对照组的8%P=0.002)。治疗组的患者及新生儿均未观察到严重不良事件。
 
由此可见,LdT不但具有更好的阻断母婴转播的循证医学证据,同时也是一个非常安全的药物。

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  3. [GetPortalCommentsPageByObjectIdResponse(id=1970146, encodeId=786419e01468b, content=<a href='/topic/show?id=a90660350f4' target=_blank style='color:#2F92EE;'>#替比夫定#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60350, encryptionId=a90660350f4, topicName=替比夫定)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2fe4321, createdName=lifangping, createdTime=Tue Nov 13 11:48:00 CST 2012, time=2012-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835551, encodeId=c9751835551a5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Thu Jul 19 03:48:00 CST 2012, time=2012-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4109, encodeId=b5224109bc, content=Many many quality pnitos there., beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=rabisankar, createdTime=Thu Mar 15 10:23:00 CST 2012, time=2012-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4105, encodeId=0a0d410570, content=This potinsg knocked my socks off, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=laquisha, createdTime=Tue Mar 13 09:17:00 CST 2012, time=2012-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1338111, encodeId=9f2013381112a, content=<a href='/topic/show?id=cd2a262068' target=_blank style='color:#2F92EE;'>#APA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2620, encryptionId=cd2a262068, topicName=APA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519126, encodeId=5ae61519126b9, content=<a href='/topic/show?id=2082286e7b' target=_blank style='color:#2F92EE;'>#ASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2867, encryptionId=2082286e7b, topicName=ASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c1a311248160, createdName=lq1771, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1598425, encodeId=284015984250f, content=<a href='/topic/show?id=a8952625e5' target=_blank style='color:#2F92EE;'>#APASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2625, encryptionId=a8952625e5, topicName=APASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b18118584502, createdName=tongyongming, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=)]
    2012-03-15 rabisankar

    Many many quality pnitos there.

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1970146, encodeId=786419e01468b, content=<a href='/topic/show?id=a90660350f4' target=_blank style='color:#2F92EE;'>#替比夫定#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60350, encryptionId=a90660350f4, topicName=替比夫定)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2fe4321, createdName=lifangping, createdTime=Tue Nov 13 11:48:00 CST 2012, time=2012-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835551, encodeId=c9751835551a5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Thu Jul 19 03:48:00 CST 2012, time=2012-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4109, encodeId=b5224109bc, content=Many many quality pnitos there., beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=rabisankar, createdTime=Thu Mar 15 10:23:00 CST 2012, time=2012-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4105, encodeId=0a0d410570, content=This potinsg knocked my socks off, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=laquisha, createdTime=Tue Mar 13 09:17:00 CST 2012, time=2012-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1338111, encodeId=9f2013381112a, content=<a href='/topic/show?id=cd2a262068' target=_blank style='color:#2F92EE;'>#APA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2620, encryptionId=cd2a262068, topicName=APA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519126, encodeId=5ae61519126b9, content=<a href='/topic/show?id=2082286e7b' target=_blank style='color:#2F92EE;'>#ASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2867, encryptionId=2082286e7b, topicName=ASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c1a311248160, createdName=lq1771, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1598425, encodeId=284015984250f, content=<a href='/topic/show?id=a8952625e5' target=_blank style='color:#2F92EE;'>#APASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2625, encryptionId=a8952625e5, topicName=APASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b18118584502, createdName=tongyongming, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=)]
    2012-03-13 laquisha

    This potinsg knocked my socks off

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1970146, encodeId=786419e01468b, content=<a href='/topic/show?id=a90660350f4' target=_blank style='color:#2F92EE;'>#替比夫定#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60350, encryptionId=a90660350f4, topicName=替比夫定)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2fe4321, createdName=lifangping, createdTime=Tue Nov 13 11:48:00 CST 2012, time=2012-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835551, encodeId=c9751835551a5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Thu Jul 19 03:48:00 CST 2012, time=2012-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4109, encodeId=b5224109bc, content=Many many quality pnitos there., beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=rabisankar, createdTime=Thu Mar 15 10:23:00 CST 2012, time=2012-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4105, encodeId=0a0d410570, content=This potinsg knocked my socks off, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=laquisha, createdTime=Tue Mar 13 09:17:00 CST 2012, time=2012-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1338111, encodeId=9f2013381112a, content=<a href='/topic/show?id=cd2a262068' target=_blank style='color:#2F92EE;'>#APA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2620, encryptionId=cd2a262068, topicName=APA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519126, encodeId=5ae61519126b9, content=<a href='/topic/show?id=2082286e7b' target=_blank style='color:#2F92EE;'>#ASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2867, encryptionId=2082286e7b, topicName=ASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c1a311248160, createdName=lq1771, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1598425, encodeId=284015984250f, content=<a href='/topic/show?id=a8952625e5' target=_blank style='color:#2F92EE;'>#APASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2625, encryptionId=a8952625e5, topicName=APASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b18118584502, createdName=tongyongming, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1970146, encodeId=786419e01468b, content=<a href='/topic/show?id=a90660350f4' target=_blank style='color:#2F92EE;'>#替比夫定#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60350, encryptionId=a90660350f4, topicName=替比夫定)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2fe4321, createdName=lifangping, createdTime=Tue Nov 13 11:48:00 CST 2012, time=2012-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1835551, encodeId=c9751835551a5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Thu Jul 19 03:48:00 CST 2012, time=2012-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4109, encodeId=b5224109bc, content=Many many quality pnitos there., beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=rabisankar, createdTime=Thu Mar 15 10:23:00 CST 2012, time=2012-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4105, encodeId=0a0d410570, content=This potinsg knocked my socks off, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=laquisha, createdTime=Tue Mar 13 09:17:00 CST 2012, time=2012-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1338111, encodeId=9f2013381112a, content=<a href='/topic/show?id=cd2a262068' target=_blank style='color:#2F92EE;'>#APA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2620, encryptionId=cd2a262068, topicName=APA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519126, encodeId=5ae61519126b9, content=<a href='/topic/show?id=2082286e7b' target=_blank style='color:#2F92EE;'>#ASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2867, encryptionId=2082286e7b, topicName=ASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c1a311248160, createdName=lq1771, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1598425, encodeId=284015984250f, content=<a href='/topic/show?id=a8952625e5' target=_blank style='color:#2F92EE;'>#APASL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2625, encryptionId=a8952625e5, topicName=APASL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b18118584502, createdName=tongyongming, createdTime=Tue Mar 06 07:48:00 CST 2012, time=2012-03-06, status=1, ipAttribution=)]
    2012-03-06 lq1771
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