叶酸用于预防结直肠腺瘤:一项随机临床试验
Bernard F Cole1, John A Baron, Robert S Sandler
1Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USA. bernard.cole@dartmouth.edu
JAMA
|June 7, 2007
概括
在一项大型临床试验中,每天1毫克的叶酸补充剂没有降低结直肠腺瘤风险. 需要进一步的研究,因为它可能会增加结直肠瘤的风险.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 营养科学 营养科学
背景情况:
- 实验室和流行病学研究表明,叶酸可能在大肠中具有抗瘤作用.
- 结肠直肠腺瘤是结肠直肠癌的前体,需要有效的预防策略.
研究的目的:
- 评估叶酸补充剂在预防结直肠腺瘤方面的安全性和有效性.
主要方法:
- 这是一项双盲,安慰剂控制的3期随机临床试验,涉及1021名具有结直肠腺瘤病史的参与者.
- 参与者每天接受1毫克叶酸或安慰剂,分别随机选择阿司匹林或安慰剂.
- 随访包括两次多年的结肠镜监测周期,以监测腺瘤的发生.
主要成果:
- 叶酸补充剂在3年 (44.1%对42.4%) 或随后的随访 (41.9%对37.2%) 中没有显著降低结直肠腺瘤的发病率.
- 晚期结直肠病变的发病率没有显著减少,并且显示了使用叶酸增加的趋势.
- 叶酸与多重腺瘤和非结肠直肠癌的风险增加有关.
结论:
- 每日补充1毫克/天的叶酸在降低结直肠腺瘤风险方面是无效的.
- 需要进一步的研究,以探索叶酸增加结直肠瘤风险的潜力.
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