不同胆固醇水平人群吸烟与冠心病死亡的关系  

The Relationship between Smoking and CHD in a Cohort Population with Different Levels of Total Blood Cholesterol

作　　者：姜斌[1] 何耀[2] 封康[2] 朱善香[2] 李良寿[3] 李兰荪[3] 

机构地区：[1]解放军总医院针灸科,北京100853 [2]解放军总医院老年医学研究所,北京100853 [3]第四军医大学,陕西西安710032

出　　处：《中国慢性病预防与控制》2006年第6期389-391,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨在不同胆固醇水平人群中吸烟与冠心病死亡的关系。方法采用Cox模型前瞻性分析西安某工厂1976年健康检查的1696名职工(男性1124,女性572)中血清总胆固醇和甘油三酯、吸烟等因素与冠心病死亡的关系。随访的终点时间为2003年1月31日。结果该队列冠心病死亡人数为59人(男性45、女性14),占总死亡人数的15.6%,总随访人.a为41827。在调整年龄、性别、婚姻状况、教育程度、职业、收缩压及甘油三酯水平后,在正常胆固醇水平组(TC<5.20mmol/L)吸烟致冠心病的死亡风险RR为2.04(95%CI:1.01～4.48),而在高胆固醇血症组(TC≥5.20mmol/L)的RR为2.36(95%CI:1.00～6.05)。分层分析显示,在胆固醇水平<4.24mmol/L、4.24～4.88mmol/L、≥4.89mmol/L组中,调整RR分别为1.97(95%CI:0.62～6.25),2.02(95%CI:0.66～6.17),2.54(95%CI:1.02～6.29),且发现吸烟与胆固醇水平可能存在某种协同作用,在高胆固醇水平组中吸烟者的冠心病死亡风险升高。结论无论人群中总胆固醇水平高低,吸烟均为冠心病的独立危险因素。Objective To examine the relationship between smoking and coronary heart disease （CHD） in a cohort with different levels of total blood cholesterol. Methods A cohort study was carried out in a machinery factory on 1 696 subjects aged 35 or above （1 124 men and 572 women） who had taken physical examination in 1976 in Xi ＇an, China, and their baseline data on systolic and diastolic blood pressure, serum cholesterol, triglyeeride and smoking history, death eases were followed up till the terminal date of Jan 31, 2003. The Cox regression model was applied to estimate relative risks （RR） and 95% confidence interval （CI）. Results By the end of this study, there were 59 death eases attributed to CHD （45 men and 14 women） and the ratio of CHD in the all deaths was 15.6%, the total person-years of the follow-up was 41 827. After adjusting the age, sex, martial status, education, occupation, systolic pressure and triglyeeride, the RRs （95% CI） of CHD death were 2.04 （1.01-4.48）in the subjects with lower blood cholesterol （〈5.20 mmol/L）and 2.36 （1.00-6.05）in higher blood cholesterol （≥ 5.20 mmol/L）. Stratified analyses showed that the adjusted RRs of CHD in three groups with TC level 〈4.24 mmol/L, 4.24-4.86 mmol/L or ≥4.89 mmol/L were 1.97 （0.62-6.25）, 2.02（0.66-6.17） and 2.54 （1.02-6.29）, respectively. Conclusion Chinese population had lower levels of total blood cholesterol than Western population. This study provided new evidence that smoking was an independent risk factor for CHD in population with different levels of TC.

关 键 词：吸烟 胆固醇 冠心病 危险因素 流行病学 

分 类 号：R541.4[医药卫生—心血管疾病] R193.3[医药卫生—内科学]