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世界核心医学期刊文摘（神经病学分册） 2005年第6期1卷 7-8页

作者： Casas J.P. Bautista l.E. smeeth l. P. Sharma 黄卫东 Hammersmith Hospital. Acute S. Imperial College London London United Kingdom Dr.

Background Individual. homozygous for the T al.el. of the MTHFR C677T pol.morphism have higher pl.sma homocysteine concentrations (the phenotype) than those with the CC genotype, which, if pathogenetic, shoul. put them at increased risk of stroke. Since this pol.morphism is distributed randoml. during gamete formation, its association with stroke shoul. not be biased or confounded. We investigated consistency between the expected odds ratio for stroke among TT homozygotes, extrapol.ted from genotype - phenotype and phenotype- disease studies, and the observed odds ratio from a meta- anal.sis of genotype- disease association studies. Methods We searched MEDl.NE and EMBASE up to June, 2003, for al. rel.vant studies on the association between homocysteine concentration and the MTHFR pol.morphism, and until.December, 2003, for those on the association between the pol.morphism and the risk of stroke. Pool.d odds ratios and 95% CI were cal.ul.ted by random- effects and fixed- effects model.. Consistency between expected and observed odds ratios was assessed by interaction test. Findings 111 studies met the sel.ction criteria. Among 15 635 peopl. without cardiovascul.r disease, the weighted mean difference in homocysteine concentration between TT and CC homozygotes was 1.93 μ mol.l.(95% CI 1.38 to 2.47). The expected odds ratio for stroke corresponding to this difference based on previous observational.studies was 1.20 (1.10 to 1.31). In our genetic meta- anal.sis (n=13 928) the odds ratio for stroke was 1.26 (1.14 to 1.40) for TT versus CC homozygotes, simil.r to the expected odds ratio (p=0.29). Consistency between the odds ratios was preserved in anal.ses by age- group, ethnic background, and geographical.l.cation. Interpretation The observed increase in risk of stroke among individual. homozygous for the MTHFR T al.el. is cl.se to that predicted from the differencesin homocysteine concentration conferred by this variant. This concordance is consistent with a causal.rel

关键词：孟德尔随机法基因多态性等位基因纯合子比值比荟萃分析心血管疾病发病风险随机模型加权平均

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与疾病相关的视力缺损和死亡率:一项英国老年人群的普查研究

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世界核心医学期刊文摘(眼科学分册) 2006年第2期 35-36页

作者： Thiagarajan M Evans J.R smeeth l. A.E. Fl.tcher 潘佳鸿 Department of Epidemiol.gy and Popul.tion Heal.h London School of Hygiene and Tropical Medicine Keppel Street London WC1E 7HT United Kingdom Dr.

Objective: To assess the association between mortal.ty and cause-specific visual.impairment in ol.er peopl.. Methods: Visual.acuity and causes of visual.impairment were col.ected in 13 569 participants 75 years and ol.er participating in a randomized trial.of heal.h screening. Participants were fol.owed up for mortal.ty for a median of 6.1 years. Resul.s: Compared with those with 6/6 (or 20/20 Snel.en) or better visual.acuity, the age-and sex-adjusted rate ratio for visual.y impaired peopl. (binocul.r visual.acuityl.en) was 1.60 (95% confidence interval. 1.47- 1.74), which was markedl. attenuated (rate ratio, 1.17; 95% confidence interval. 1.07- 1.27) after adjustment for confounding factors. Peopl. whose visual.impairment was due to cataract or age-rel.ted macul.r degeneration had excess risks of al.-cause and cardiovascul.r mortal.ty, which disappeared after adjustment. Peopl. with refractive error remained at smal. risk, despite adjustment, probabl. owing to residual.confounding from factors associated with minimal.use of eye services rather than underl.ing eye disease. There were no associations with cancer mortal.ty. Concl.sion: Associations reported for visual.impairment and mortal.ty or for specific causes of visual.impairment refl.ct confounding by comorbidities, risk factors, and other factors rel.ted to susceptibil.ty to death rather than an independent biol.gical.association of vision probl.ms or specific eye diseases.

关键词：视力疾病死亡率老年人群

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社区中急性感染后深静脉血栓形成和肺栓塞的风险

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世界核心医学期刊文摘（心脏病学分册） 2006年第7期2卷 4-4页

作者： smeeth l. Cook C. Thomas S. 罗亮 Departments of Epidemiol.gy and Popul.tion Heal.h London School of Hygiene and Tropical Medicine London WC1E 7HT United Kingdom Dr.

Background: Acute infection increases the risk of arterial.cardiovascul.r events, but effects on venous thromboembol.c disease are l.ss wel. establ.shed. Our aim was to investigate whether acute infections transientl. increase the risk of venous thromboembol.sm. Methods: We used the sel.-control.ed case-series method to study the risk of first deep vein thrombosis(DVT)(n=7278) and first pul.onary embol.sm(PE)(n=3755) after acute respiratory and urinary tract infections. Data were obtained from records from general.practices who had registered patients with the UK’s Heal.h Improvement Network database between 1987 and 2004. Findings: The risks of DVT and PE were significantl. raised, and were highest in the first two weeks, after urinary tract infection. The incidence ratio for DVT was 2.10(95%CI 1.56-2.82), and that for PE 2.11(1.38-3.23). The risk gradual.y fel. over the subsequent months, returning to the basel.ne val.e after 1 year. The risk of DVT was al.o higher after respiratory tract infection, but possibl. diagnostic miscl.ssification precl.ded a rel.abl. estimate of the risk of PE after respiratory infection. Interpretation: Acute infections are associated with a transient increased risk of venous thromboembol.c events in a community setting. Our resul.s confirm that infection shoul. be added to the l.st of precipitants for venous thromboembol.sm, and suggest a causal.rel.tion.

关键词：肺栓塞深静脉血栓形成静脉血栓栓塞全科医师动脉性心血管事件尿路感染呼吸道感染病例记录

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老年性黄斑变性与应用他汀类药物的病例对照研究

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世界核心医学期刊文摘（眼科学分册） 2005年第12期1卷 38-39页

作者： smeeth l.Cook C Chakravarthy U 王静波 Department of Epidemiol.gy and Popul.tion Heal.h London School of Hygiene and Tropical Medicine Keppel Street London WC1E 7HT United Kingdom.Dr

Aims: Age rel.ted macul.r degeneration (AMD) is the l.ading cause of bl.ndness in industrial.sed countries. Previous studies have suggested that statins may have a protective effect against the disease; however, existing studies have had l.mited power to rel.abl. detect or excl.de an effect and have produced confl.cting resul.s. The authors assessed the risk of AMD associated with the use of statins. Methods: Popul.tion based case control.study using the United Kingdom General.Practice Research Database. 18 007 peopl. with diagnosed AMD were compared with 86 169 control. matched on age, sex, and general.practice. The primary outcome was the odds ratio for the association between exposure to statins and AMD. Resul.s: The crude odds ratio for the association between any recorded exposure to statins and AMD was 1.32 (95% CI 1.17 to 1.48), but this reduced to 0.93 (95% CI 0.81 to 1.07, p=0.33) after adjustment for consul.ation rate, smoking, al.ohol.intake, body mass index, atheroscl.rotic disease, hyperl.pidaemia, heart fail.re, diabetes mel.itus, hypertension, use of other cardiovascul.r drugs, and use of fibrates. There was no evidence that the risk varied by dose of statin, duration of use, or that the risk varied for individual.statins. Concl.sion: In the short and medium term statin use is not associated with a decreased risk of AMD. Whether subgroups of patients with specific forms of AMD (particul.rl. choroidal.neovascul.risation) benefit from statin therapy remains a possibil.ty.

关键词：老年性黄斑变性他汀类药物病例对照研究脉络膜新生血管致盲原因心血管药物患病风险心脏衰竭脂血症亚群

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特定原因的视力损害与死亡率基于英国老龄人口的研究结果

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美国医学会眼科杂志（中文版） 2006年第4期18卷 247-248页

作者： Manickam Thiagarajan Jennifer R. Ethos l.am smeeth Richard P. l. Wormal. Astrid E. Fl.tcher 陈慧瑾（译）

目的：评价老年人的死亡率与特定原因的视力损害之间的联系。方法：总共13569位年龄在75岁以上的老人参加了健康筛查的随机试验．试验收集患者的视力及视力损害的原因。随访时间直至参加者死亡．平均时间为6．1年。

关键词：视力损害死亡率老龄人口英国随机试验健康筛查随访时间老年人

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中国全科医学 2018年第27期 3284-3284页

作者： IWAGAM IM CAPl.N B smeeth l.本刊编辑部

背景虽然慢性肾脏病可引起多种不良后果,但是其引起的何种疾病/症状导致了患者住院,还未为人知。目的定量研究慢性肾脏病和病因别住院之间的相关性。设计与场所本研究为配对队列研究。使用的数据来自英国临床研究数据库（CPRD）及其链... 详细信息

背景虽然慢性肾脏病可引起多种不良后果,但是其引起的何种疾病/症状导致了患者住院,还未为人知。目的定量研究慢性肾脏病和病因别住院之间的相关性。设计与场所本研究为配对队列研究。使用的数据来自英国临床研究数据库（CPRD）及其链接到的医院住院患者统计数据库（HES）。方法研究对象为2004—2014年间诊治的慢性肾脏病患者[连续3个月或者3个月以上估算肾小球滤过率l.min-1·（1.73 m2）-1,慢性肾脏病组]和年龄、性别、经治疗的全科医生素质和治疗日期相匹配的非慢性肾脏病患者（对照组）。首次住院时诊断的疾病被认定为入院原因,主要包括10种常见病:心力衰竭、尿路感染、肺炎、急性肾损伤、心肌梗死、脑梗死、消化道出血、髋部骨折、静脉血栓栓塞、颅内出血。对慢性肾脏病组和对照组首次住院时每一种疾病的发生率进行了对比。对每一种疾病的相对患病风险进行多因素Cox回归分析。结果共纳入了242 349对研究对象。慢性肾脏病组（9.7‰）和对照组（3.1‰）因为心力衰竭发病而住院的人年比例差值最大（6.6‰）,其次为尿路感染（5.2‰）、肺炎（4.4‰）、急性肾损伤（4.1‰）。急性肾损伤的相对发病风险最高,调整HR值为4.90[95%CI（4.47,5.38）],其次为心力衰竭,调整HR值为1.66[95%CI（1.59,1.75）]。结论慢性肾脏病患者同时患有心力衰竭、尿路感染或急性肾损伤有更高的绝对和/或相对住院风险,建议对此类人群加强预防性护理。

关键词：慢性肾脏病对照组肾损伤队列研究相关性

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