郑美丽,王清涛,惠汝太,霍勇,徐希平,杨新春

• 1:首都医科大学附属北京朝阳医院心脏中心
• 2:首都医科大学附属北京朝阳医院检验科
• 3:中国医学科学院阜外心血管病医院高血压诊治中心
• 4:北京大学第一医院心血管内科

摘要(Abstract)：

同型半胱氨酸(homocysteine,Hcy)不但是脑卒中发生的独立危险因子,而且与高血压有协同作用,被《中国高血压防治指南(2010版)》确定为心血管八大危险因素之一。脑卒中是我国居民第一位死因,由于遗传和生活习惯的差异,中国人群的Hcy水平显著高于西方国家,因此在我国强调控制高血压的同时,加强控制高Hcy水平等其他脑卒中高发危险因素意义更加重大。国内外大量研究证明,在叶酸缺乏或者没有强化叶酸的地区,Hcy水平高于10μmol/L的人群脑卒中发生率显著增加,尤其是对于同时伴有高血压的患者而言;补充叶酸以降低Hcy水平能够显著降低脑卒中发生风险。此外,没有资料表明Hcy在人体内具有重要生理功能,关于补充叶酸以预防心脑血管事件发生的研究在Hcy水平较低的受试人群也仍然显示了有益的效果,而且补充小剂量叶酸以降低血浆Hcy水平(即使在<10μmol/L的情况下)在降低脑卒中发生风险的同时并不增加其他任何健康风险。《中国高血压防治指南》制定的高Hcy Cut Off值(>10μmol/L)可作为我国医务工作者规范开展脑卒中预防工作的参考,在临床实践中,提高Hcy的Cut Off值(如>12μmol/L或>15μmol/L)等将使大量潜在脑卒中高发人群得不到及时关注和干预,增加脑卒中发生风险,尤其是在高血压患者群中。因此在中国高血压患者群中较好地控制血浆Hcy水平对于开展我国脑卒中防治工作有着重要意义。

关键词(KeyWords)：

Abstract:

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基金项目(Foundation):

作者(Author): 郑美丽,王清涛,惠汝太,霍勇,徐希平,杨新春

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