吸烟对血管内皮功能的损害:1∶1配对分析  

Vascular endothelial functional damage caused by smoking:one-to-one paired analysis

作　　者：孙晓鸥[1] 陈书静 张明[3] 高金库[1] 

机构地区：[1]鞍山市中心医院心内科,辽宁省鞍山市114001 [2]铁岭市中西医结合医院内科,辽宁省铁岭市112000 [3]辽宁省人民医院心内科,辽宁省沈阳市110016

出　　处：《中国临床康复》2005年第15期12-13,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察吸烟及其吸烟量不同对中老年吸烟人群血管内皮功能的影响。方法:选择2004-05/2004-10在鞍山市中心医院门诊进行健康体格检查者167人。纳入自愿参加实验的吸烟健康体检者85人为吸烟组。排除戒烟已超过2年者和确诊为肺心病和其他器质性心脏病患者。按相同性别、年龄、身高、体质量、职业1∶1配对为不吸烟组(n=85),不吸烟是指一生中从未吸烟。共配成85对,其中男67对,女18对。根据吸烟者的吸烟指数将其分为大量吸烟组(吸烟指数≥100年支,n=39)和小量吸烟组(吸烟指数<100年支,n=46)。使用HP2500型彩色多普勒超声仪,同时记录肢体导联心电图,判断心动周期的舒张末期,测定3个心动周期肱动脉前后内膜之间的距离,取其均值。每位受试者分别测定安静时肱动脉内径,之后进行反应性充血试验,测血流介导的肱动脉内径,休息10min后,舌下含服硝酸甘油后3.5～4.0min再次测定含服硝酸甘油后肱动脉内径。反应性充血及含服硝酸甘油后血管内径的变化分别代表血管内皮依赖性舒张功能和非依赖性舒张功能。结果:按意向处理分析,吸烟组安静时肱动脉内径、血管内皮依赖性舒张功能和血流介导的肱动脉血流量增长百分比均明显低于不吸烟组(4.38±0.79)mm,(4.50±1.09)%,(217.8±99.6)%;(4.51±0.83)mm,(10.51±3.17)%,(375.AIM:To observe the effects of smoking and different smoking amount on the vascular endothelial function among middle-aged and elderly smoking group. METHODS:Totally 167 healthy physical examinees in the clinic of Anshan Central Hospital between May and October 2004 were selected, and 85 of them, who were smokers,took part in the study voluntarily(smoking group).Those who had stopped smoking for more than 2 years and patients diagnosed to have pulmonary heart disease and other organic cardiopathy were excluded.Eighty-five non-smokers(non-smoking group),who had never smoked all his life,were matched one to one with the same gender,age,body height,body mass and profession.A total of 85 pairs were matched,67 pairs were male and 18 pairs were female.According to the smoking index,the smokers were divided into large amount smoking group(smoking index≥100 year·piece,n=39) and small amount smoking group(smoking index< 100 year·piece,n=46).HP2500 color Doppler ultrasound was applied,and limb lead electrocardiography was recorded at the same time,the diastasis of cardiac cycle was judged,the distances between the anterior and posterior endometriums of tracheal artery in 3 cardiac cycles were determined, and the mean value was obtained.The resting internal diameter of brachial artery of each subject was determined,the blood stream mediated internal diameter of brachial artery was determined after reactive hyperemia test;After 10-minute rest,the internal diameter of tracheal artery was determined again 3.5 to 4 minutes after sublingual medication of nitroglycerin.The changes of vascular internal diameter after reactive hyperemia and holding nitroglycerin in the mouth represented the vascular endothelial dependent and independent diastolic functions respectively. RESULTS:According to intention-to-treat analysis,the resting internal diameter of brachial artery,vascular endothelial dependent diastolic function and brachial artery mediated blood flow increasing percentage were obviously lower in the smoking group[(4.38±

关 键 词：血管内皮功能 血管内皮依赖性舒张功能 配对分析 肱动脉内径 彩色多普勒超声仪 反应性充血 吸烟指数 硝酸甘油 意向处理分析 大量吸烟 心动周期 血流介导 健康体检者 心脏病患者 导联心电图 动脉血流量 吸烟人群 健康体格 

分 类 号：R541.4[医药卫生—心血管疾病] R135.2[医药卫生—内科学]