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[同型半胱氨酸代谢紊乱作为心血管疾病发生的危险因素:对预后的影响及药物纠正的可能性]

[Disturbances of homocysteine metabolism as a risk factor of cardiovascular diseases development: effect on prognosis and possibilities of correction with drugs].

作者信息

Shakhmatova O O, Komarov A L, Panchenko E P

出版信息

Kardiologiia. 2010;50(1):42-50.

Abstract

Classical risk factors of development of cardiovascular diseases does not allow to detect all persons needing active prevention. Because of this reason great attention is given to novel biomarkers one of which is homocysteine. Most widely-spread causes of elevation of homocysteine level are such factors as deficit of folic acid and B6 and B12 vitamins, as well as genetic peculiarities. Main damaging effect of homocysteine is activation of atherothrombosis. Therapy with folic acid causes significant lowering of homocysteine level. Effect of therapy with vitamins on the risk of development of cardiovascular diseases has been assessed both in observational epidemiological studies and large prospective randomized trials. Their results are controversial. The present review is devoted to the analysis of these trials.

摘要

心血管疾病发生的经典风险因素无法检测出所有需要积极预防的人群。因此,人们对新型生物标志物给予了极大关注,同型半胱氨酸就是其中之一。同型半胱氨酸水平升高最常见的原因是叶酸、维生素B6和B12缺乏等因素,以及遗传特性。同型半胱氨酸的主要损害作用是激活动脉粥样硬化血栓形成。叶酸治疗可使同型半胱氨酸水平显著降低。维生素治疗对心血管疾病发生风险的影响已在观察性流行病学研究和大型前瞻性随机试验中进行了评估。它们的结果存在争议。本综述致力于对这些试验进行分析。

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