Naruszewicz M, Klinke M, Dziewanowski K, Staniewicz A, Bukowska H
Regional Center for Atherosclerosis Research, Pomeranian Academy of Medicine, and the Dialysis Unit of the Provincial Hospital, Szczecin, Poland.
Metabolism. 2001 Feb;50(2):131-4. doi: 10.1053/meta.2001.20174.
Ischemic heart disease and other complications of atherosclerosis are the usual cause of death in patients with chronic renal failure. Important factors associated with early onset of atherosclerosis in these patients are hyperhomocysteinemia, hyperfibrinogenemia, and elevated levels of lipoprotein(a) (Lp(a)). Folic acid (15 mg/d), pyridoxine (150 mg/d), and cyanocobalamin (1 mg/wk) were administered for 4 weeks in 21 patients receiving dialysis, and a simultaneous, statistically significant reduction in the concentration of homocysteine, fibrinogen, and Lp(a) was found. A positive correlation between decreasing homocysteine and fibrinogen levels was also noted. The parameters studied approached presupplementation values 6 months after vitamins were discontinued. The results suggest that vitamin supplementation has a favorable effect on risk factors of atherosclerosis in patients with renal failure and that interactions may exist between homocysteine, fibrinogen, and Lp(a).
缺血性心脏病和动脉粥样硬化的其他并发症是慢性肾衰竭患者常见的死亡原因。这些患者动脉粥样硬化早期发作的重要相关因素是高同型半胱氨酸血症、高纤维蛋白原血症和脂蛋白(a) [Lp(a)]水平升高。对21例接受透析的患者给予叶酸（15毫克/天）、吡哆醇（150毫克/天）和氰钴胺（1毫克/周），为期4周，同时发现同型半胱氨酸、纤维蛋白原和Lp(a)的浓度有统计学意义的显著降低。还注意到同型半胱氨酸水平降低与纤维蛋白原水平之间呈正相关。在停用维生素6个月后，所研究的参数接近补充前的值。结果表明，补充维生素对肾衰竭患者动脉粥样硬化的危险因素有有利影响，并且同型半胱氨酸、纤维蛋白原和Lp(a)之间可能存在相互作用。
