diff --git a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java
index ee835dc2..35ae54b5 100644
--- a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java
+++ b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java
@@ -95,7 +95,6 @@ public class MedicalRecManageServiceImpl implements MedicalRecManageService {
             askPatientAnswer.setLibraryQuestionId(medicalRecQaVO.getLibraryQuestionId());
             askPatientAnswer.setAnswer(medicalRecQaVO.getMedicalRecAnswer());
             askPatientAnswer.setMedicalId(medicalRec.getId());
-            askPatientAnswer.setPatientId(patient.getId());
             askPatientAnswer.insert();
         }
     }
@@ -184,7 +183,6 @@ public class MedicalRecManageServiceImpl implements MedicalRecManageService {
                 askPatientAnswer.setLibraryQuestionId(medicalRecQaVO.getLibraryQuestionId());
                 askPatientAnswer.setAnswer(medicalRecQaVO.getMedicalRecAnswer());
                 askPatientAnswer.setMedicalId(medicalRec.getId());
-                askPatientAnswer.setPatientId(patient.getId());
                 askPatientAnswer.insert();
             }
         }
diff --git a/virtual-patient-model/src/main/java/com/supervision/model/AskPatientAnswer.java b/virtual-patient-model/src/main/java/com/supervision/model/AskPatientAnswer.java
index bdc2ff02..82dce8ab 100644
--- a/virtual-patient-model/src/main/java/com/supervision/model/AskPatientAnswer.java
+++ b/virtual-patient-model/src/main/java/com/supervision/model/AskPatientAnswer.java
@@ -26,11 +26,6 @@ public class AskPatientAnswer extends Model<AskPatientAnswer> implements Seriali
     @TableId
     private String id;
 
-    /**
-     * 病人ID
-     */
-    private String patientId;
-
 
     @ApiModelProperty("病例id")
     private String medicalId;
diff --git a/virtual-patient-model/src/main/resources/mapper/AskPatientAnswerMapper.xml b/virtual-patient-model/src/main/resources/mapper/AskPatientAnswerMapper.xml
index e79f4bbc..ba972fbb 100644
--- a/virtual-patient-model/src/main/resources/mapper/AskPatientAnswerMapper.xml
+++ b/virtual-patient-model/src/main/resources/mapper/AskPatientAnswerMapper.xml
@@ -6,7 +6,6 @@
 
     <resultMap id="BaseResultMap" type="com.supervision.model.AskPatientAnswer">
             <id property="id" column="id" jdbcType="VARCHAR"/>
-            <result property="patientId" column="patient_id" jdbcType="VARCHAR"/>
             <result property="medicalId" column="medical_id" jdbcType="VARCHAR"/>
             <result property="libraryQuestionId" column="library_question_id" jdbcType="VARCHAR"/>
             <result property="answer" column="answer" jdbcType="VARCHAR"/>
@@ -18,7 +17,7 @@
     </resultMap>
 
     <sql id="Base_Column_List">
-        id,patient_id,medical_id,library_question_id,
+        id,medical_id,library_question_id,
         answer,answer_resources_id,create_user_id,
         create_time,update_user_id,update_time
     </sql>
diff --git a/virtual-patient-web/src/main/java/com/supervision/service/impl/AskDiagnosisResultServiceImpl.java b/virtual-patient-web/src/main/java/com/supervision/service/impl/AskDiagnosisResultServiceImpl.java
index 63449689..ca61f8f1 100644
--- a/virtual-patient-web/src/main/java/com/supervision/service/impl/AskDiagnosisResultServiceImpl.java
+++ b/virtual-patient-web/src/main/java/com/supervision/service/impl/AskDiagnosisResultServiceImpl.java
@@ -56,13 +56,12 @@ public class AskDiagnosisResultServiceImpl implements AskDiagnosisResultService
         DiagnosisResultResVO diagnosisResultResVO = new DiagnosisResultResVO();
         diagnosisResultResVO.setId(processId);
         Process process = processService.getById(processId);
-        Patient patient = patientService.getById(process.getPatientId());
         MedicalRec medicalRec = medicalRecService.getById(process.getMedicalRecId());
         List<Disease> diseasesList = diseaseService.listDiseaseWithType(medicalRec.getDiseaseId());
         // 1.生成预期诊断结果
         diagnosisResultResVO.setExpertDiagnosisResult(creatExpertDiagnosisResult(medicalRec, diseasesList, processId));
         // 2.生成初步诊断依据
-        diagnosisResultResVO.setBasisPrimaryResultResVO(createBasisPrimaryResult(patient, medicalRec, process));
+        diagnosisResultResVO.setBasisPrimaryResultResVO(createBasisPrimaryResult(medicalRec, process));
         // 3.生成证实诊断依据
         diagnosisResultResVO.setBasisConfirmResultResVO(createBasisConfirmResult(medicalRec, processId));
         // 4.生成鉴别诊断依据
@@ -180,7 +179,7 @@ public class AskDiagnosisResultServiceImpl implements AskDiagnosisResultService
         return basisConfirmResultResVO;
     }
 
-    private BasisPrimaryResultResVO createBasisPrimaryResult(Patient patient, MedicalRec medicalRec, Process process) {
+    private BasisPrimaryResultResVO createBasisPrimaryResult( MedicalRec medicalRec, Process process) {
         BasisPrimaryResultResVO basisPrimaryResultResVO = new BasisPrimaryResultResVO();
         // 初步诊断依据 vp_medical_rec的primarily_diagnosis_criteria
         basisPrimaryResultResVO.setPreliminaryDiagnosis(medicalRec.getPrimarilyDiagnosisCriteria());
@@ -190,7 +189,7 @@ public class AskDiagnosisResultServiceImpl implements AskDiagnosisResultService
         List<DiagnosisQaRecord> qaRecordList = diagnosisQaRecordService.lambdaQuery().eq(DiagnosisQaRecord::getProcessId, process.getId()).list();
         if (CollectionUtil.isNotEmpty(qaRecordList)) {
             List<AskPatientAnswer> list = askPatientAnswerService.lambdaQuery()
-                    .eq(AskPatientAnswer::getPatientId, patient.getId()).list();
+                    .eq(AskPatientAnswer::getMedicalId, medicalRec.getId()).list();
             // 获取配置了答案的项目(配置了答案的,认为是正确,没有配置答案的,走默认回答的,不标记为以正确)
             Set<String> requireCheckIdSet = list.stream().map(AskPatientAnswer::getId).collect(Collectors.toSet());
             List<BasisDiagnosisNodeResVO> qaList = qaRecordList.stream().map(e -> {