Clinical Evaluation of Lowering the Morbidity of Cerebrovascular Disease and the Plasma Cysteine Levels by B Group Vitamins Based on Meta-analysis / 中国药师

ABSTRACT

Objective:To assess the effect of B group vitamins on cerebrovascular diseases, and also to evaluate the relationship between B group vitamins and homocysteine(Hcy). Methods:Using the words homocysteine,folic acid,folate,cerebrovascular dis-ease,B group vitamins and randomized controlled trial as the keywords,PubMed,the Cochrane library,WanFang Database,VIP and CNKI were searched. The randomized controlled trials about preventive effect of folic acid,vitamin B12or vitamin B6on cerebrovascular disease occurring published between 1998 and July 2016 were searched by manually retrieving relevant journals. Two reviewers inde-pendently screened the trials,extracted the data and evaluated the quality of included trials. The Cochrane Collaboration's RevMan 5.3 software was used for the statistical analysis. Results:Twelve trials involving 36 053 patients were included. The results of meta-analysis showed that B group vitamins could lower the risk of stroke(RR=0.90,95% CI0.82-0.99,P=0.02). The sensitivity a-nalysis conducted after the exclusion of low-quality trials did not change the overall results, and B group vitamins could lower plasma Hcy concentration (MD= -3.40,95% CI-4.21--2.59, P<0.000 01). Conclusion: B group vitamins can lower plasma Hcy concentration,and lower the risk of stroke. B group vitamins supplementation should be recommended for the secondary prevention of stroke. The results of this study still need more reasonable design combined with strict implementation of larger samples of randomized double-blind controlled trials.