h-高血压与叶酸代谢基因mthfr—培训课件.pptVIP

* * * 进一步，来自欧洲大样本人群的数据显示，Hcy与不同危险因素同时存在时，呈现不同的交互作用， Graham 研究表明：血浆tHcy升高可明显增强高血压心脑血管疾病的危险性，较正常人增加28倍，呈现明显的放大作用，属于血管性疾病极高危的危险因素。 * * H型高血压的概念自08年初提出，经过反复论证，08年12月，胡大一教授正式在《中华内科杂志》上作出了明确定义，即伴有伴有血浆同型半胱氨酸升高(Hcy10umol/L)的原发性高血压定义为H型高血压，治疗H型高血压迅速成为我国脑卒中预防的新思路 * * * 由于高HCY合并高血压作为血管疾病最重要的危险因素的危害和转归的严重性，我们学组的霍勇教授牵头在全国六大城市轻中度高血压人群中进行调查，发现我国H型高血压在高血压中占比高达75%。我国2亿高血压患者预计有近1.5亿为H型，及其相关流行病学特征、致病机制、诊断治疗的特殊性和临床转归意义，我国学者将这种“伴有同型半胱氨酸水平升高的高血压称为H型高血压。 2005年，柳叶刀的一篇荟萃分析表明：MTHFRC677T TT基因型与脑卒中发生的OR值为1.26，增加风险26% * * * * 中国人群MTHFR 与脑卒中关联强于国外数据，表明Hcy在中国危害更为严重 * * * 药物基因组学提供了一个非常有吸引力的选择。想像有一天当你进入你的医生的办公室，经过简单，快速测试你的DNA ，你的医生改变她/他的用药主意，因为您的基因测试表明，你可以受到严重的负面反应药物治疗。然而，经过进一步审查您的测试结果，你的医生认为，您将大大受益于一个新药品，并且很少可能产生副反应。 研究人员预计，该药品的未来不但外观和工作原理与现代的药物不同，而且明天的药物是根据您的基因制定的。了解你的独特的基因构成可以帮助你的医生开出正确的处方同时保证正确的计量，提高其效率，尽量减少可能带来的副作用 Pharmacogenomics offers a very appealing alternative. Imagine a day when you go into your doctors office and, after a simple and rapid test of your DNA, your doctor changes her/his mind about a drug considered for you because your genetic test indicates that you could suffer a severe negative reaction to the medication. However, upon further examination of your test results, your doctor finds that you would benefit greatly from a new drug on the market, and that there would be little likelihood that you would react negatively to it. Researchers predict that the medicines of the future may not only look and work differently than those you take today, but tomorrows medicines will be tailored to your genes. Knowing your unique genetic make-up could help your doctor prescribe the right medicine in the right amount, to boost its effectiveness and minimize possible side effects. /medbydesign/foreword.html A pharmacogenetic study of ACEI on blood pressure was conducted in 444 hypertensive patients, aged 27 to 65 years, without any recent anti hypertensive therapy. Compared to subjects in the lowest tertile of Delta DBP, the adjusted relative odds of having the TT genotype among subject