目的:研究血浆同型半胱氨酸(Hcy)及相关因素在年龄相关性黄斑变性(AMD)各中医证型中的变化及意义,观察Hcy是否为中国人群AMD发病的危险因素。方法:采集52例AMD患者的血液样本,并以19例正常健康者作对照,酶联免疫法测定空腹血浆Hcy水平,同时检测超氧化物歧化酶(SOD)、丙二醛(MDA)、血脂等生化指标水平。分析Hcy等指标与AMD中医证型的关系及相关因素对Hcy的影响,寻找AMD发病的危险因素。结果:Hcy水平在痰凝瘀滞型组、肝肾亏虚型组均高于对照组(P<0.05),三证型组间比较无差异。Hcy与SOD水平呈负相关。SOD水平在痰凝瘀滞型组、肝肾亏虚型组均低于对照组及痰湿蕴结型组。MDA,TC,LDL-C水平在各证型组的均不同程度升高(P>0.05),TC水平在痰凝瘀滞型组、肝肾亏虚型组高于对照组(P<0.05);HDL-C水平组间比较无差异。结论:高Hcy可能通过多种致病途径在痰凝瘀滞型与肝肾亏虚型AMD中发挥作用,但未发现是AMD发病的高风险因素;高TC,LDL-C可能是痰浊蕴结型AMD辨证和病程进展的微观指标;高TC,TG,LDL-C可能是痰凝瘀滞型、肝肾亏虚型AMD的生化物质基础;SOD水平减少、MDA生成增多可能为AMD发生发展的提供了病理基础。

·AIM:To study the changes and significance of the serum plasma homocysteine(Hcy),superoxide dismutase(SOD),malondialdehyde(MDA)and serum lipid levels within age-related macular degeneration(AMD)TCM syndrome types,and to observe if Hcy level is a risk factor in AMD among Chinese population.·METHODS:Fifty-two AMD patients’ blood samples were collected with 19 healthy samples as control.The fasting Hcy levels were measured by euzyme-linked immunosorbent assay.SOD,MDA,and blood fat concentration were also measured.And different AMD TCM syndrome types and all these indexes were analyzed to find the influence on Hcy from the related factors and the independent factor of AMD.·RESULTS:The Hcy levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than those of the control(P<0.05),yet no differences were detected among three case groups.Results demonstrated negative correlation between Hcy and SOD level.SOD levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than controls and phlegm syndrome group(P<0.05),while TC level was higher than controls(P<0.05);MDA,TC and LDL-C levels in all groups were elevated to different degrees(P<0.05).No difference of HDL-C level among four groups was found.·CONCLUSION:Hyperhomocysteine may play roles in phlegm-blood stasis syndrome and liver-kidney deficiency syndrome AMD by various pathogenic mechanisms,but was not a risk factor of AMD in this survey.Increased TC and LDL-C levels may be indexes of stage increasing in phlegm syndrome group.Increased TC,TG and LDL-C may be some of the useful markers of phlegm-blood stasis syndrome and liver-kidney deficiency syndrome.Decreased SOD and increased MDA may be regarded as pathological basis in AMD.·

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