Mayer Otto, Filipovský Jan, Hromádka Milan, Svobodová Vlasta, Racek Jaroslav, Mayer Otto, Stehlík Pavel, Trefil Ladislav, Zárybnická Marta
Department of Clinical Pharmacology, University Hospital, Plzen, Czech Republic.
J Cardiovasc Pharmacol. 2002 Jun;39(6):851-7. doi: 10.1097/00005344-200206000-00010.
The aim of the study was to determine whether folic acid treatment in subjects with homocysteinemia would change their coagulation and oxidative status. Thirty-three patients with peripheral vascular disease and 26 elderly subjects with no symptoms of atherosclerosis, all of whom had total homocysteine >20 microM, were treated with folic acid (5 or 10 mg) for 3 months. In the 33 patients with peripheral vascular disease, homocysteine levels decreased from a median of 26.7 microM at baseline to 20.0 microM (p < 0.0001), whereas in the 26 asymptomatic elderly subjects, homocysteine level decreased from 24.4 microM to 18.6 microM (p < 0.0001). Plasma fibrinogen decreased whereas plasminogen and anti-thrombin increased; the differences between pre- and posttreatment values were significant in both patients and healthy subjects. Oxidative status markers showed a shift toward lower oxidative stress. This effect was observed in both study groups. An association of the therapeutic effect with the genetic polymorphism of 5,10-methylenetetrahydrofolate reductase was not detected. Folic acid supplementation to hyperhomocysteinemic subjects resulted in a decrease in total blood homocysteine concentrations; moreover, there was a tendency to reverse the coagulation status and oxidative stress.
该研究的目的是确定对高同型半胱氨酸血症患者进行叶酸治疗是否会改变他们的凝血和氧化状态。33例外周血管疾病患者和26例无动脉粥样硬化症状的老年受试者，所有受试者的总同型半胱氨酸均>20μM，接受叶酸（5或10mg）治疗3个月。在33例外周血管疾病患者中，同型半胱氨酸水平从基线时的中位数26.7μM降至20.0μM（p<0.0001），而在26例无症状老年受试者中，同型半胱氨酸水平从24.4μM降至18.6μM（p<0.0001）。血浆纤维蛋白原降低，而纤溶酶原和抗凝血酶增加；治疗前后的值在患者和健康受试者中均有显著差异。氧化状态标志物显示向较低氧化应激转变。在两个研究组中均观察到这种效应。未检测到治疗效果与5,10-亚甲基四氢叶酸还原酶基因多态性之间的关联。对高同型半胱氨酸血症受试者补充叶酸导致全血同型半胱氨酸浓度降低；此外，有逆转凝血状态和氧化应激的趋势。
