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叶酸在心脑血管疾病防治中的机遇与挑战

成彦琼,  张浩,  王威,  顾小飞,  刘爱军

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文章导航 > 药学实践与服务  > 2013 >  31(5): 330-333,350
成彦琼, 张浩, 王威, 顾小飞, 刘爱军. 叶酸在心脑血管疾病防治中的机遇与挑战[J]. 药学实践与服务, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
引用本文: 成彦琼, 张浩, 王威, 顾小飞, 刘爱军. 叶酸在心脑血管疾病防治中的机遇与挑战[J]. 药学实践与服务, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
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CHENG Yan-qiong, ZHANG Hao, WANG Wei, GU Xiao-fei, LIU Ai-jun. New challenge of folic acid on prevention of cardiovascular and cerebrovascular diseases[J]. Journal of Pharmaceutical Practice and Service, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
Citation: CHENG Yan-qiong, ZHANG Hao, WANG Wei, GU Xiao-fei, LIU Ai-jun. New challenge of folic acid on prevention of cardiovascular and cerebrovascular diseases[J]. Journal of Pharmaceutical Practice and Service, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
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叶酸在心脑血管疾病防治中的机遇与挑战

doi: 10.3969/j.issn.1006-0111.2013.05.003
  • 1.

    第二军医大学长海医院泌尿外科, 上海 200433;第二军医大学药学院药理学教研室, 上海 200433

  • 2.

    第二军医大学药学院药理学教研室, 上海 200433

基金项目: 国家自然科学基金资助项目(81273505).

New challenge of folic acid on prevention of cardiovascular and cerebrovascular diseases

  • 1.

    Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai 200433, China

  • 2.

    Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai 200433, China

  • 摘要: 叶酸缺乏可导致高同型半胱氨酸血症,而高同型半胱氨酸血症是心脑血管疾病的独立危险因素。过去认为补充叶酸可降低体内同型半胱氨酸水平,从而预防心脑血管疾病的发生。但随着大量临床随机对照试验的进行,人们发现降低同型半胱氨酸血症并不能为心血管疾病患者带来益处,脑卒中方面的益处还需要更多临床数据证明。叶酸等B族维生素在心脑血管疾病的预防领域还存在着很大的挑战。笔者就目前叶酸等在心脑血管疾病中的应用现状及存在问题作一综述。
    Abstract: The lack of folic acid which could cause hyperhomocysteine had revealed an obviously relationship with cardiovascular and cerebrovascular diseases. Plenty of studies had shown that hyperhomocysteine was an independent risk factor of cardiovascular and cerebrovascular diseases. Folic acid supplementation might be an effective method to decrease homocysteine and prevent cardiovascular and cerebrovascular diseases,while some studies question about it. So there was a new challenge of folic acid on prevention of cardiovascular and cerebrovascular diseases.
  • [1] Collaboration HLT.Lowering blood homocysteine with folic acid based supplements:meta-analysis of randomized trials [J].BMJ,1998,316(7135):894.
    [2] Selhub J,Jacques PF,Wilson PW,et al.Vitamin status and intake as primary determinants of homocysteinemia in an elderly population[J].JAMA,1993,270(22):2693.
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    [4] Gottsater A,Forsblad J,Mattiasson I,et al.Decreasing plasma endothelin-1 and unchanged plasma neopterin during folate supplementation in hyperhomocysteinemia[J].Int Angiol,2002,21(2):158.
    [5] McCully KS.Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis[J].Am J Pathol,1969,56 (1):111.
    [6] Wilcken DE,Wilcken B.The pathogenesis of coronary artery disease. A possible role for methionine metabolism[J].J Clin Invest,1976,57 (4):1079.
    [7] Ward M.Homocysteine,folate and cardiovascular disease[J].Int J Vitam Nutr Res,2001,71(3):173.
    [8] Homocysteine Lowering Trialists' Collaboration.Dose-dependent effects of folic acid on blood concentrations of homocysteine: a meta-analysis of the randomized trials[J].Am J Clin Nutr, 2005,82(4):806.
    [9] Homocysteine Studies Collaboration.Homocysteine and risk of ischemic heart disease and stroke:a meta-analysis[J].JAMA,2002,288(16): 2015.
    [10] Kelly PJ,Rosand J,Kistler JP,et al.Homocysteine, MTHFR 677C→T polymorphism, and risk of ischemic stroke:results of a meta-analysis[J].Neurology, 2002, 59(4):529.
    [11] Lewis SJ,Ebrahim S,Davey Smith G.Meta-analysis of MTHFR 677C→T polymorphism and coronary heart disease:does totality of evidence support causal role for homocysteine and preventive potential of folate[J].BMJ, 2005,331(7524):1053.
    [12] Sarkar PK, Lambert LA. Aetiology and treatment of hyperhomocysteinaemia causing ischaemic stroke[J].Int J Clin Pract,2001,55(4):262.
    [13] Oncel C,Demir S,Güler S,et al.Association between cholesterols,homocysteine and silent brain infarcts[J].Intern Med J,2009,39(3):150.
    [14] Homocysteine Lowering Trialists' Collaboration.Dose-dependent effects of folic acid on blood concentrations of homocysteine:A meta-analysis of the randomized trials[J].Am J Clin Nutr.2005,82(4): 806.
    [15] Fallon UB,Virtamo J,Young I,et al.Homocysteine and cerebral infarction in finnish male smokers[J].Stroke,2003,34(6):280.
    [16] Liu AJ,Guo JM,Xia WL,et al.The new strategies for the prevention of stroke[J].Clin Exp Pharmacol Physiol,2009,37(2):265.
    [17] Sánchez-Moreno C,Jiménez-Escrig A, Martín A.Stroke:roles of B vitamins,homocysteine and antioxidants[J].Nutr Res Rev,2009,22(1):49.
    [18] Woo KS,Chook P,Chan LL, et al. Long-term improvement in homocystein levels and arterial endothelial function after 1-year folic acid supplementation[J].Am J Med,2002,112(7):535.
    [19] Title IM,Cummings PM,Giddens K,et al.Effect of folic acid and antioxidant vitamins on endothelial dysfunction in patients with coronary artery disease[J].J Am Coll Cardiol,2000,36(3):758.
    [20] Chambers JC,Ueland PM,Obeid OA,et al.Improved vascular endothelial function after oral B vitamins: an effect mediated through reduced concentrations of free plasma homocysteine[J].Circulation,2000,102(20):2479.
    [21] Lonn E,Yusuf S,Arnold MJ.Homocysteine Lowering with folic acid and B vitamins in vascular disease[J].N Engl J Med,2006,54(15):1567.
    [22] SEARCH Study Collaborative Group,Bowman L,Armitage J,et al.Study of the effectiveness of additional reductions in cholesterol and homocysteine (SEARCH): characteristics of a randomized trial among 12 064 myocardial infarction survivors[J].Am Heart J,2007,154(5):815.
    [23] Ebbing M,Bleie O,Ueland PM,et al.Mortality and cardiovascular events in patients treated with homocysteine-lowering B vitamins after coronary angiography:a randomized controlled trial[J].JAMA,2008,300(7):795.
    [24] Albert CM,Cook NR,Gaziano JM,et al.Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial[J].JAMA, 2008,299(17):2027.
    [25] Bφnaa KH, Njφlstad I, Ueland PM, et al. Homocysteine lowering and cardiovascular events after acute myocardial infarction[J].N Engl J Med, 2006, 354(15):1578.
    [26] Wrone EM, Hornberger JM,Zehnder JL,et al.Randomized trial of folic acid for prevention of cardiovascular events in end-stage renal disease[J].J Am Soc Nephrol,2004,15(2):420.
    [27] Liem AH,van Boven AJ,Veeger NJ,et al.Efficacy of folic acid when added to statin therapy in patients with hypercholesterolemia following acute myocardial infarction:a randomized pilot trial[J].Int J Cardiol,2004,93(2-3):175.
    [28] Zoungas S,McGrath BP,Branley P,et al.Cardiovascular morbidity and mortality in the Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) in chronic renal failure: a multicenter, randomized, controlled trial[J].J Am Coll Cardiol 2006,47(6):1108.
    [29] Bazzano LA,Reynolds K,Holder KN,et al.Effect of folic acid supplementation on risk of cardiovascular diseases:a meta-analysis of randomized controlled trials[J].JAMA,2006,296(22):2720.
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  • [1] 徐璐璐, 刘爱军.  丹参白术方“异病同治”冠心病、血管性痴呆、特发性膜性肾病的网络药理学作用机制研究 . 药学实践与服务, 2024, 42(12): 1-8. doi: 10.12206/j.issn.2097-2024.202312027
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出版历程
  • 收稿日期:  2012-12-14
  • 修回日期:  2013-04-08

叶酸在心脑血管疾病防治中的机遇与挑战

doi: 10.3969/j.issn.1006-0111.2013.05.003
  • 1. 第二军医大学长海医院泌尿外科, 上海 200433;第二军医大学药学院药理学教研室, 上海 200433
  • 2. 第二军医大学药学院药理学教研室, 上海 200433
    • 基金项目:  国家自然科学基金资助项目(81273505).
  • 收稿日期: 2012-12-14
  • 修回日期: 2013-04-08

摘要: 叶酸缺乏可导致高同型半胱氨酸血症,而高同型半胱氨酸血症是心脑血管疾病的独立危险因素。过去认为补充叶酸可降低体内同型半胱氨酸水平,从而预防心脑血管疾病的发生。但随着大量临床随机对照试验的进行,人们发现降低同型半胱氨酸血症并不能为心血管疾病患者带来益处,脑卒中方面的益处还需要更多临床数据证明。叶酸等B族维生素在心脑血管疾病的预防领域还存在着很大的挑战。笔者就目前叶酸等在心脑血管疾病中的应用现状及存在问题作一综述。

English Abstract

成彦琼, 张浩, 王威, 顾小飞, 刘爱军. 叶酸在心脑血管疾病防治中的机遇与挑战[J]. 药学实践与服务, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
引用本文: 成彦琼, 张浩, 王威, 顾小飞, 刘爱军. 叶酸在心脑血管疾病防治中的机遇与挑战[J]. 药学实践与服务, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
shu
CHENG Yan-qiong, ZHANG Hao, WANG Wei, GU Xiao-fei, LIU Ai-jun. New challenge of folic acid on prevention of cardiovascular and cerebrovascular diseases[J]. Journal of Pharmaceutical Practice and Service, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
Citation: CHENG Yan-qiong, ZHANG Hao, WANG Wei, GU Xiao-fei, LIU Ai-jun. New challenge of folic acid on prevention of cardiovascular and cerebrovascular diseases[J]. Journal of Pharmaceutical Practice and Service, 2013, 31(5): 330-333,350. doi: 10.3969/j.issn.1006-0111.2013.05.003
shu

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