叶黄素和玉米黄质在糖尿病视网膜病变中的临床应用

Application of lutein and zeaxanthin in diabetic retinopathy

目的观察糖尿病视网膜病变(diabetic retinopathy,DR)患者与正常人血清中叶黄素和玉米黄质的浓度是否有差异性;补充叶黄素和玉米黄质后血清叶黄素和玉米黄质水平的变化及视功能的改变。方法测量30名(60眼)正常人(正常对照组)和30例(60眼)单纯型DR患者(试验组)血清中叶黄素和玉米黄质的浓度。对入选的30例DR患者补充叶黄素和玉米黄质3个月。测定补充前和补充后1个月、2个月、3个月的视力以及补充前和补充后1个月、3个月的血清叶黄素和玉米黄质浓度。结果 DR组患者血清叶黄素和玉米黄质浓度分别为(0.069±0.029)mg·L-1、(0.014±0.006)mg·L-1与正常对照组(0.230±0.131)mg·L-1、(0.046±0.027)mg·L-1相比明显降低(均为P=0.000);DR组服用后1个月、2个月、3个月视力分别为0.411±0.321、0.443±0.335、0.457±0.334,较服用前的视力0.382±0.298显著提高(P=0.000);服用后1个月血清叶黄素和玉米黄质浓度分别为(0.475±0.192)mg·L-1、(0.177±0.107)mg·L-1;服用后3个月分别为(0.541±0.181)mg·L-1、(0.282±0.073)mg·L-1,较服用前显著升高(P=0.000)。结论单纯型DR患者血清叶黄素和玉米黄质的浓度明显低于正常人,经过补充叶黄素和玉米黄质后患者叶黄素和玉米黄质的浓度有明显上升,视力有明显改善。叶黄素和玉米黄质在早期DR的治疗方面有很大的潜力和应用价值。

Objective To observe the difference of lutein and zeaxanthin concentrations in the serum between the patients with diabetic retinopathy（DR） and the normal,and observe the changes of lutein and zeaxanthin concentrations in the serum and visual function after supplying the patients with lutein and zeaxanthin.Methods The lutein and zeaxanthin concentrations in the serum were measured in 30 patients with DR and 30 normal subjects,and analyze the data.The DR patients were supplied with lutein and zeaxanthin for 3 months.The visual acuity before supplying and at 1 month,2 months,3 months after supplying were examined,the lutein and zeaxanthin concentrations at 1 month and 3 months were also examined.Results The lutein and zeaxanthin concentrations in the serum of DR patients before supplying were（0.069±0.029）mg·L-1,（0.014±0.006）mg·L-1,lower than that of normal subjects,which were（0.230±0.131）mg·L-1,（0.046±0.027）mg·L-1,there were significant differences（All P=0.000）.The visual acuity at 1 month,2 months,3 months after supplying were 0.411±0.321,0.443±0.335,0.457±0.334,which were better than that before supplying（0.382±0.298）,there was statistical difference（P=0.000）.The lutein and zeaxanthin concentrations in the serum of DR patients at 1month after supplying were（0.475±0.192）mg·L^-1,（0.177±0.107）mg·L^-1,at 3 months after supplying were（0.541±0.181）mg·L^-1,（0.282±0.073）mg·L^-1,there was significant difference compared with that before supplying（P=0.000）.Conclusion The lutein and zeaxanthin concentrations in the serum of DR patients are significantly lower than that of the normal,which all increases after supplying,and the visual acuity improves obviously.Therefore,lutein and zeaxanthin play an important role in the early treatment of DR.