我们的网站为什么显示成这样?

可能因为您的浏览器不支持样式,您可以更新您的浏览器到最新版本,以获取对此功能的支持,访问下面的网站,获取关于浏览器的信息:

|本期目录/Table of Contents|

补充叶酸及B族维生素对冠心病患者血管内皮功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第2期
页码:
184-186
栏目:
临床研究
出版日期:
2008-03-20

文章信息/Info

Title:
Effects of supplementation of folic acid and B Vitamins on endothelial function in coronary heart disease patients
作者:
谢莲娜1王丽君1孙玉兰1曲虹2刘新荣1郑荣芳1王秉香1
大连市友谊医院:1.心内科,2.功能科 ,辽宁 大连 116001
Author(s):
XIE Lianna1 WANG Lijun1 SUN Yulan1 QU Hong2 LIU Xinrong1 ZHENG Rongfang1 WANG Bingxiang1
1.Department of Cardiology,2. Department of Ultrasound, Dalian Friendship Hospital, Dalian 116001, Liaoning, China
关键词:
冠状动脉疾病 叶酸B族维生素血管内皮功能同型半胱氨酸
Keywords:
coronary heart disease folic acid B vitamins vascular endothelial function homocysteine
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 探讨在常规治疗基础上补充叶酸及B族维生素是否能改善冠心病(CHD)患者的血管内皮功能。方法 经冠脉造影检查至少一支冠状动脉狭窄≥50%的连续CHD患者87例,在包括阿司匹林及他汀类调脂药等的常规治疗基础上随机分为两组。试药组(45例):在常规治疗的基础上加服叶酸 15 mg/d;维生素B6 30 mg/d;维生素B12 75 μg/d;对照组(42例):常规治疗。治疗半年,于治疗前后采用HP SONOS 5500型彩色超声显像仪和3.0~117.0 MHZ的线阵探头,分别测量患者休息时、反应性充血后肱动脉内径。比较治疗前后内皮依赖性血管舒张功能(flowmediated dilation ,FMD)的变化。结果 治疗前,试药组与对照组间肱动脉基础内径[(4.2±0.5)mm vs (4.6±0.4)mm]及反应充血引起的肱动脉内径变化差异无统计学意义[(3.9±0.9)% vs (4.1±0.5)%]。半年后两组患者反应充血引起的肱动脉内径变化均较自身治疗前明显改善[试药组(3.9±0.9)% vs (15.5±5.4)%,P<0.01;对照组[(4.1±5)% vs (14.0±6.3)%, P<0.01],但两组反应充血引起的肱动脉内径变化差异无统计学意义[(15.5±5.4)% vs (14.0±6.3)%]。结论 含阿司匹林及他汀类调脂药的CHD常规治疗能明显改善CHD患者的血管内皮功能,在常规治疗基础上补充叶酸及B族维生素对改善CHD患者血管内皮功能的作用不优于CHD常规治疗。
Abstract:
AIM To explore whether supplementation of folic acid and B vitamins will improve endothelial dysfunction in patients with coronary heart disease (CHD). METHODS Vascular ultrasound was used to assess the effect of folic acid and B vitamins on brachial artery flowmediated dilation (FMD). Eightyseven patients with CHD (documented by coronary angiography at least one coronary artery’s stenosis ≥50%) were randomized equally to two groups: routine treatment (include aspirin and statins) and routine treatment pulse folic acid and B vitamins (folic acid 15 mg/d, vitamin B12 75 μg/d, vitamin B6 30 mg/d). The patients were treated for six months. FMD were measured before and after the six months of treatment. RESULTS Before treatment, there were no significant differences between control and treatment groups in diameter of brachial artery [(4.2±0.5)mm vs (4.6±0.4)mm] and FMD [(3.9±0.9)% vs (4.1±0.5)%]. After the sixmonth treatment, FMD showed significantly improvement in both groups: in routine treatment group from (4.1±0.5)% to (14.0±6.3)% (P<0.01) and in routine treatment pulse folic acid and B vitamins group from (3.9±0.9)% to (15.5±5.4)% (P<0.01). But there was no significant difference in FMD’s improvement between the two groups [(15.5±5.4)% vs (14.0±6.3)%]. CONCLUSION Routine treatment, including aspirin and statins, significantly improves endothelial dysfunction in patients with CHD. Supplementation of folic acid and B vitamins does not further improve endothelial dysfunction.

参考文献/References

[1] Whincup PH, Refsum H, Perry IJ, et al. Serum total homocysteine and coronary heart disease: prospective study in middle aged men [J] . Heart ,1999 , 82(4):448-454.

[2] Stehouwer CD, Weijenberg MP, van den Berg M, et al. Serum homocysteine and risk of coronary heart disease and cerebrovascular disease in elderly men: a 10year followup[J]. Arterioscler Thromb Vasc Biol, 1998 , 18(12):1895-1901

[3] Mujumdar VS, Aru GM, Tyagi SC. Induction of oxidative stress by homocyst(e)ine impairs endothelial function[J]. J Cell Biochem, 2001,82(3):491-500.

[4] Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by lowdose folic acid combined with vitamins B6 and B12[J]. Am J Cardiol, 1999, 83(6):821-825.

[5] Celermajer DS,Sokense NK,Gooch VM, et al. Noninvasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis[J]. Lancet,1992,340(8828):1111-1115.

[6] Title LM, Cummings PM, Giddens K, et al. Affect of folic acid and antioxidant vitamins on endothelial dysfunction in patients with coronary artery disease[J]. J Am Coll Cardiol,2000, 36(3):758-765.

[7] Tyagi SC, Smiley LM, Mujumdar VS,et al. Reductionoxidation (Redox) and vascular tissue level of homocyst(e)ine in human coronary atherosclerotic lesions and role in extracellular matrix remodeling and vascular tone[J]. Mol Cell Biochem,1998, 181(12):107-116.

[8] Boushey CJ, Beresford SA, Omenn GS, et al. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes[J]. JAMA,1995 , 274(13):1049-1057.

备注/Memo

备注/Memo:
收稿日期:2007-01-22.作者简介:谢莲娜,主任医师,硕士Email:xieln@yahoo.com.cn
更新日期/Last Update: