同型半胱氨酸与冠状动脉粥样硬化性心脏病的相关性研究进展  

Advances in Association between Homocysteine and Coronary Heart Disease

作　　者：曾双龙[1,2] 徐俊波[2] 胡咏梅[2] 

机构地区：[1]遵义医学院,贵州遵义563003 [2]成都市第二人民医院心内科,四川成都610017

出　　处：《心血管病学进展》2012年第5期650-653,共4页Advances in Cardiovascular Diseases

摘　　要：虽然经历了40余年的漫长研究,但高同型半胱氨酸血症是冠状动脉粥样硬化性心脏病的预测因子还是危险因素目前仍无定论。系列临床观察性研究及其荟萃分析一致显示轻、中度高同型半胱氨酸血症对冠状动脉粥样硬化性心脏病的发生和预后有独立预测价值,而近期以冠状动脉粥样硬化性心脏病患者为主要研究对象的大型随机对照试验却证实补充维生素B(包括叶酸)尽管能有效降低血浆同型半胱氨酸水平,但不能减少心血管事件,尤其是冠状动脉粥样硬化性心脏病事件,这对高同型半胱氨酸血症在冠状动脉粥样硬化性心脏病发病中的作用提出了质疑。为更好地指导临床抉择,现对近年来两者的相关性研究进展做一综述。The road of the research has lasted for more than forty years ,hut it is not clear whether hyperhomocysteinemia is a risk factor （ = associated with the target disease and causally involved in its development） or a risk indicator （ = associated with the target disease but not causally involved with its development） for coronary heart disease. A number of observational studies and meta-analyses have found that mild to moderate hyperhomocysteinemia has independent predict effect for the incidence and prognosis of cardiovascular disease. However, the recent large randomized controlled trials have confirmed that vitamin B supplementation （ including folic acid） can reduce plasma ho- mocysteine level effectively, but it cannot reduce the risk of cardiovascular events, especially coronary heart disease events,which have cast doubt on the role of hyperhomocysteinemia in coronary heart disease pathogenesis. In order to provide the basis for the recent clinical choice, this review focuses on the studies of the association between homocysteine and coronary heart disease.

关 键 词：同型半胱氨酸 冠状动脉粥样硬化性心脏病 危险因素 维生素B 叶酸 

分 类 号：R541.4[医药卫生—心血管疾病]