摘要：Context: Basi. research provi.es plausi.le m.chani.m. and observati.nal studi.s suggest that apparently healthy persons, who self-select for hi.h i.takes of vi.am.0} E through di.t or supplem.nts, have decreased ri.ks of cardi.vascular di.ease and cancer. Random.0}ed tri.ls do not generally support benefi.s of vi.am.0} E, but there are few tri.ls of long durati.n am.ng i.i.i.lly healthy persons. Objecti.e: To test whether vi.am.0} E supplem.ntati.n decreases ri.ks of cardi.vascular di.ease and cancer am.ng healthy wom.n. Desi.n, Setti.g, and Parti.i.ants: i. the Wom.n’s Health Study conducted between 1992 and 2004, 39 876 apparently healthy US wom.n aged at least 45 years were random.y assi.ned to recei.e vi.am.0} E or placebo and aspi.i. or placebo, usi.g a 2×2 factori.l desi.n, and were followed up for an average of 10.1 years. i.terventi.n: Adm.0}i.trati.n of 600 i. of natural-source vi.am.0} E on alternate days. m.i. Outcom. m.asures: Pri.ary outcom.s were a com.osi.e end poi.t of fi.st m.jor cardi.vascular event(nonfatal m.ocardi.l i.farcti.n, nonfatal stroke, or cardi.vascular death) and total i.vasi.e cancer. Results: Duri.g follow-up, there were 482 m.jor cardi.vascular events i. the vi.am.0} E group and 517 i. the placebo group, a nonsi.ni.i.ant 7%ri.k reducti.n(relati.e ri.k[RR], 0.93; 95%confi.ence i.terval[Ci., 0.82-1.05; P=.26). There were no si.ni.i.ant effects on the i.ci.ences of m.ocardi.l i.farcti.n(RR, 1.01; 95%Ci. 0.82-1.23; P=.96) or stroke(RR, 0.98; 95%Ci. 0.82-1.17; P=.82), as well as i.chem.0} or hem.rrhagi. stroke. For cardi.vascular death, there was a si.ni.i.ant 24%reducti.n(RR, 0.76; 95%Ci. 0.59-0.98; P=.03). There was no si.ni.i.ant effect on the i.ci.ences of total cancer(1437 cases i. the vi.am.0} E group and 1428 i. the placebo group; RR, 1.01; 95%Ci. 0.94-1.08; P=.87) or breast(RR, 1.00; 95%Ci. 0.90-1.12; P=.95), lung(RR, 1.09; 95%Ci. 0.83-1.44; P=.52), or colon cancers(RR, 1.00; 95%Ci. 0.77-1.31; P=.99). Cancer deaths also di. not di.fer si.n

摘要：背景:PPA(phenylpropanolam.0}e,苯丙醇胺)常见于食欲抑制药和咳嗽感冒药中,以往病例报告表明含PPA的药物与出血性中风有关,通常发生在首次使用后。为阐明二者相关性,我们设计了一项病例对照研究。方法:18～49岁的男、女性研究病例来自美国43所医院,其合格标准包括在参与项目前30天内发生蛛网膜下腔出血或颅内出血,而既往并无确诊的脑损伤史。采用随机电话拨号,为每个病例安排2例对照进行面访。结果:调查人群包括702名病例和1376名对照。女性服用含PPA食欲抑制药和出血性中风危险之间相关联的调整比值比为16.58(95％可信区间1.51～182.21,P=0.02);女性首次服用含PPA药物与出血性中风危险之间关联的调整比值比3.13(95％可信区间0.86～11.46,P=0.08),所有首次服用的PPA皆为咳嗽感冒药。男、女性调查人群服用含PPA药物与出血性中风危险二者关联的调整比值比为1.49(95％可信区间0.84～2.64.P=0.17);男、女性调查人群服用含PPA的咳嗽感冒药与出血性中风危险二者关联的调整比值比为1.23(95％可信区间0.68～2.24,P=0.49),服用舍PPA的食欲抑制药与出血性中风危险关联的调整比值比为15.92(95％可信区间1.38～184.13,p=0.03)。对男性的分析结果表明:服用含PPA的咳嗽感冒药未引起出血性中风危险增加,男性无一例使用?