吸烟对冠心病的影响I:血浆维生素E的作用  

Effect of Smoking on the Coronary Heart Disease:The Role of Plasma Vitamin E

作　　者：程龙献[1] 蒋长征[2] 何美安[2] 郑红燕[2] 胡丙长[2] 邬堂春[2] 

机构地区：[1]武汉华中科技大学同济医学院附属协和医院心血管病研究所,武汉430022 [2]华中科技大学同济医学院劳动卫生与环境卫生学系,武汉430030

出　　处：《环境与职业医学》2004年第4期261-263,共3页Journal of Environmental and Occupational Medicine

基　　金：国家自然基金海外青年合作研究基金 (编号 :30 1 2 80 2 1 );教育部高等学校优秀青年教师教学和科研奖励计划;国家重点基础研究规划项目 (编号 :2 0 0 2CB51 2 90 5)

摘　　要：[目的 ]研究吸烟对血浆维生素E(VitE)在冠心病中的作用的影响。 [方法 ]随机整群抽样的方式选取了武汉市 3家大型医院和 3个社区 ,按照WHO冠心病诊断标准 ,选择冠心病病人 15 8人 ,年龄匹配的健康对照 2 72人。使用标准化的调查表获得研究对象的基本资料 ;采用高效液相色谱法测定了他们血浆中VitE的含量。 [结果 ]吸烟增加了冠心病的风险 (调节OR :3 .42 ;95 %可信区间 (CI) :2 .2 8～ 5 .3 2 )。测得的VitE的浓度范围是 0 .5～ 5 7.0 μmol/L。在不吸烟的研究对象中 ,VitE表现出中等强度的保护效应 ,调节其他混杂因素后OR值及 95 %CI分别为 0 .3 5和 0 .18～ 0 .69。但在吸烟的研究对象中没有发现有意义的保护效应 ,调节其他混杂因素后OR值及 95 %CI分别为 0 .60和 0 .2 6～ 1.3 5。[结论 ]吸烟是冠心病的独立危险因素 。Objective To explore the effect of smoking on the action of vitamin E in coronary heart disease(CHD).[Methods] Cases were incident CHD diagnosed based on WHO's standards in three of the major hospitals in Wuhan.Controls were healthy volunteers from three communities,matched for age,they have no CHD history,chronic vascular diseases and other severe diseases.A total of 158 patients with confirmed CHD and 272 age-matched controls consented and were included in the present study. Participants' information and data were obtained by a standard questionnaire.Plasma was isolated to determine concentrations of vitamin E by high performance liquid chromatography(HPLC).[Results] Our results showed that smoking increased the risk of CHD(adjusted OR:3.42;95%CI:2.28～5.32).The distribution of plasma vitamin E was in a range of 0.5～57.0μmol/L.The protection afforded by high concentrations of vitamin E was more marked among lifetime-nonsmokers(adjusted OR:0.35;95%CI:0.18～0.69) than among current and ex-smokers (adjusted OR:0.60;95%CI:0.26～1.35). [Conclusion] These results suggested that smoking is an independent risk factor and it attenuates the protection effect of vitamin E against the occurrence of CHD.

关 键 词：冠心病 吸烟 血浆 OR值 保护效应 维生素E 混杂因素 研究对象 中等 结论 

分 类 号：R541.4[医药卫生—心血管疾病] R163[医药卫生—内科学]