叶黄素对颈动脉粥样硬化斑块炎性反应程度的影响

Effect of Lutein on the Inflammatory Response of Carotid Atherosclerotic Plaques

目的:探讨叶黄素对颈动脉粥样硬化斑块炎性反应程度的影响。方法:连续纳入于解放军总医院就诊的颈动脉粥样硬化患者169名,随机分为安慰剂组(淀粉胶囊,1次/日)、低剂量组(叶黄素20 mg,1次/日)、中剂量组(叶黄素40 mg,1次/日)、高剂量组(叶黄素60 mg,1次/日)。每名患者分别于确定参加实验的1周内及服药结束后行血液样本采集以及正电子发射断层显像(positron emission tomography-computed tomography,PET-CT)技术检查。服药期为12个月。对每名患者实验开始及实验结束的两次血液学标本均进行血常规、血生化、炎性因子及药物浓度方面的检测。颈动脉斑块PET-CT检查,计算18氟-脱氧葡萄糖摄取值的标准化值(target-to-background ratio,TBR),以此反映斑块炎性反应程度。结果:叶黄素干预后,低、中、高剂量3组患者的叶黄素血药浓度均显著升高。与正常组及自身服药前的基线水平相比较,叶黄素干预后的低、中、高剂量3组患者TBR均显著降低,而且干预剂量越大,TBR的降低越明显。结论:叶黄素可以减轻颈动脉粥样硬化斑块的炎性反应程度,对心脑血管事件的发生具有一定的预防作用。

Objective： To investigate the effect of lutein on the inflammatory response of carotid atherosclerotic plaques. Methods： Totally 169 consecutive carotid atherosclerosis patients from the General Hospital of PLA were recruited, and randomly divided into placebo （starch capsule, at once-daily dose）, low-dose （20 mg/d）, middle-dose （40 mg/d）, and high-dose lutein （60 mg/d） groups. Each patient was subjected to the collection of venous blood sample and positron emission tomography-computed tomography （PET-CT） examination within 1 week of the trial and after the end of the medication. The medication period was 12 months. Routine blood examination, blood biochemical indexes, inflammatory factors and drug concentration were detected in two blood samples of each patient. The carotid plaque was examined by PET-CT, and target-to-background ratio （TBR） was calculated to reflect the degree of plaque inflammatory response. Results： The serum concentrations of lutein in three treatment groups at low, medium and high doses were increased when compared with those at the beginning of the trial. Compared with the placebo group and the baseline level, the patients from the treatment groups had a signiflcant decrease in TBR. The higher dose resulted in a greater decrease of TBR. Conclusion： Lutein can reduce the inflammatory response of carotid atherosclerotic plaques and have a deflnitely preventive effect on the occurrence of cardiovascular and cerebrovascular events.