同型半胱氨酸介绍.pptVIP

荟萃分析确认叶酸预防脑卒中有效 Lancet 2007; 369: 1876-82 循证证据4 心血管事件高危人群强化叶酸治疗 脑卒中事件显著获益 5522例有心血管疾病史或糖尿病/ 动脉粥样硬化等危险因素 随机、双盲、安慰剂对照，随访5 年 治疗组： 2.5mg 叶酸、50-mg VB6和1mg VB12 主要结果： 治疗组卒中发生的相对风险 较安慰剂组降低25% （p=0.03） N Engl J Med 2006;354. 叶酸干预研究：HOPE2 25% HOPE2再分析 亚组人群中叶酸具有更强疗效 Stroke. 2009;40 脑卒中病人降Hcy的获益 VISP:Re-analysis Concerning the effect of folic acid fortification of grain products in patients; Patients who would be more likely to respond to vitamin therapy , with GFR above the 10th percentile for calculated GFR (46.18) and with serum B12 levels in the 25th to 95th percentiles (250 to 637 pmol/L) were selected. Stroke. 2005;36:2404-2409. 循证证据7 VITATOPS研究证实降hcy对脑卒中患者获益 脑卒中患者减少血管性死亡14%（P0.05） Lancet Neurol 2010;9(9):855-65. Michael V Holmesa,?, Paul Newcombef,g,?, Jaroslav A Hubacekh, Reecha Sofatb, Sally L Rickettsi, Jackie Cooperc, Monique MB Bretelern,o, Leonelo E Bautistap, Pankaj Sharmaq, John C Whittakerf,g, Liam Smeethf, F Gerald R Fowkesr, Ale Algras,v, Veronika Shmelevat, Zoltan Szolnokiu, Mark Roestw, Michael Linnebankx, Jeppe Zachoy, Michael A Nallsz, Andrew B Singletonz, Luigi Ferrucciaa, John Hardye, Bradford B Worrallab, Stephen S Richac, Mar Matarind, Paul E Normanad, Leon Flickerae,ah, Osvaldo P Almeidaaf,ah,ai, Frank M van Bockxmeerag,aj, Hiroshi Shimokataak, Kay-Tee Khawj, Nicholas J Warehamk, Martin Bobaka, Jonathan AC Sterneam, George Davey Smithal, Philippa J Talmudc, Cornelia van Duijnn, Steve E Humphriesc, Jackie F Pricer, Shah Ebrahimf, Debbie A Lawloral, Graeme J Hankeyae, James F Meschiaan, Manjinder S Sandhul,m, Aroon D Hingorania,b, and Juan P Casasa,f,* Research Department of Epidemiology and Public Health, University College London, London, UK bDepartment of Clinical Pharmacology, University College London, London, UK cCentre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK dDepartment of Clinical and Experimental Epilepsy, University College Lond