目的：研究老年性黄斑变性( AMD)等级、血清抗氧化维生素水平(维生素A、C和E)和吸烟的关系。 方法：对84例患者行黄斑彩色眼底成像,根据AMD损伤率和损伤程度将其分为五组(等级I~V)。应用高效液相色谱法( HPLC)测量血清抗氧化维生素水平。根据吸烟状况分不吸烟者、已戒烟者和吸烟者三组,并统计吸烟者每年的吸烟总量。 结果：对照组中,维生素A、E、C水平分别为0.874依0.326mg/L,10.739依4.874mg/L和1.737依0.447mg/L,AMD组中分别为0.880依0.305mg/L,9.487依6.060mg/L 和1.870依2.191mg/L,无显著差异(P>0.05)。 AMD不同等级分组间维生素A(P=0.881)和E(P=0.293)水平差异无统计学意义,维生素C水平( P=0.044)随AMD程度的加深而增加。根据吸烟状况,AMD组与对照组之间无显著差异。根据每年的吸烟总量,两组之间有显著差异(P=0.02)。AMD越严重,年吸烟总量越高( P=0.007)。 结论：研究结果显示AMD与维生素A、E血清水平无关,但和维生素C的血清水平相关,并与吸烟量有关。%AIM: To evaluate associations between the grades of age related macular degeneration ( AMD ) and serum levels of antioxidant vitamins ( vitamin A, C and E) and smoking. METHODS:Fifty-three AMD patients and 31 individuals having ages matching with the patient group were enrolled the study. Colored fundus photographs of the macula were used to place participants ( n=84 ) into one of the five groups ( Grade I-V ) based on the frequency and severity of the lesions associated with AMD. Serum antioxidant vitamin levels were measured using High Performance Liquid Chromatography ( HPLC ) . Smoking status was classified as non-smoker, ex-smoker and current smoker. Total number of packs smoked per year, was defined. RESULTS:The distribution of vitamin A, E, and C levels were 0. 874±0. 326mg/L, 10. 739±4. 874mg/L, 1. 737±0.447mg/L in control group and 0. 880±0. 305mg/L, 9. 487±6. 060mg/L, 1. 870±2. 191mg/L in AMD group, respectively. The difference between AMD and control group was not statistically significant for vitamin A, E and C levels ( P>0.05 ) . There were no significant differences between subgroups of AMD for vitamin A (P=0. 881) and vitamin E (P=0. 293) but there was a contradicting rise of vitamin C levels ( P=0. 044 ) with increasing levels of the disease. There were no significant differences between AMD and control group regarding smoking status, but there was a significant difference for total number of packs smoked per year (P=0. 02). An increase of number of total packs smoked per year was determined along with the rising grade of AMD (P=0. 007). CONCLUSION:We found no relation between AMD and serum levels of vitamin A and E but vitamin C levels was increase with AMD grades unexpectedly. We found dose-response relationship between smoking and AMD.
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