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曾经有过短暂性脑缺血发作或卒中的患者应用叶酸、维生素B_(12)和维生素B_6降低高半胱氨酸的治疗不能降低血管炎症、内皮功能异常或高凝的血液学标记物:VITATOPS试验的随机亚研究 被引量:1
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作者 Dusitanond P. Eikelboom J.W. +1 位作者 Hankey G.J. 邓剑平 《世界核心医学期刊文摘(神经病学分册)》 2005年第6期59-59,共1页
Background and Purpose - Epidemiological and laboratory studies suggest that increasing concentrations of plasma homocysteine (total homocysteine [tHcy]) accelerate cardiovascular disease by promoting vascular inflamm... Background and Purpose - Epidemiological and laboratory studies suggest that increasing concentrations of plasma homocysteine (total homocysteine [tHcy]) accelerate cardiovascular disease by promoting vascular inflammation, endothelial dysfunction, and hypercoagulability. Methods - We conducted a randomized controlled trial in 285 patients with recent transient ischemic attack or stroke to examine the effect of lowering tHcy with folic acid 2 mg, vitamin B12 0.5 mg, and vitamin B6 25 mg compared with placebo on laboratory markers of vascular inflammation, endothelial dysfunction, and hypercoagulability. Results - At 6 months after randomization, there was no significant difference in blood concentrations of markers of vascular inflammation (high- sensitivity C- reactive protein [P=0.32]; soluble CD40L [P=0.33]; IL- 6 [P=0.77]), endothelial dysfunction (vascular cell adhesion molecule- 1 [P=0.27]; intercellular adhesion molecule- 1 [P=0.08]; von Willebrand factor [P=0.92]), and hypercoagulability (P- selectin [P=0.33]; prothrombin fragment 1 and 2 [P=0.81]; D- dimer [P=0.88]) among patients assigned vitamin therapy compared with placebo despite a 3.7- μ mol/L (95% CI, 2.7 to 4.7) reduction in total homocysteine (tHcy). Conclusions - Lowering tHcy by 3.7 μ mol/L with folic acidbased multivitamin therapy does not significantly reduce blood concentrations of the biomarkers of inflammation, endothelial dysfunction, or hypercoagulability measured in our study. The possible explanations for our findings are: (1) these biomarkers are not sensitive to the effects of lowering tHcy (eg, multiple risk factor interventions may be required); (2) elevated tHcy causes cardiovascular disease by mechanisms other than the biomarkers measured; or (3) elevated tHcy is a noncausal marker of increased vascular risk. 展开更多
关键词 VITATOPS 高半胱氨酸 内皮功能异常 血管炎症 黏连分子 选择素 心血管病 血管细胞 凝血酶原 高敏感
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