吸烟与冠状动脉粥样硬化程度关系的研究  

A study on relationship between smoking and severity of coronary atherosclerosis

作　　者：郭纪群[1] 贾恩志[1] 杨志健[1] 

机构地区：[1]南京医科大学第一附属医院心内科

出　　处：《南京医科大学学报（自然科学版）》2007年第10期1187-1192,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金资助(30400173)

摘　　要：目的:探讨吸烟与冠状动脉粥样硬化程度之间的关系。方法:回顾性分析南京医科大学第一附属医院心导管室的冠状动脉造影1060例,将其冠脉病变按Gensini积分系统进行评估,将吸烟量、Gensini积分与其它18项生理、生化指标及胆固醇/高密度脂蛋白胆固醇(CH/HDL-C)、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C),载脂蛋白A/载脂蛋白B(apoA/apoB)之间行二变量的Spearman相关性分析,并将吸烟量与Gensini积分之间作控制年龄、性别变量后的偏相关分析,以及将是否吸烟为分组变量进行独立变量的t检验,再将Gensini积分与各危险因素作多元逐步回归分析。结果:吸烟量与白细胞计数、中性粒细胞计数、CH/HDL-C、LDL-C/HDL-C,Gensini积分存在正相关关系,白细胞计数、中性粒细胞计数、CH/HDL-C、LDL-C/HDL-C与Gensini积分存在正相关关系。在控制年龄、性别变量后吸烟量仍与积分存在线性剂量反应关系。吸烟与非吸烟组之间白细胞计数、中性粒细胞计数、CH/HDL-C、LDL-C/HDL-C,Gensini积分的差异具有统计学意义。多元逐步回归分析结果显示中性粒细胞、吸烟指数、LDL-C/HDL-C为冠状动脉粥样硬化的独立危险因素。结论:吸烟与冠状动脉粥样硬化程度是独立相关的,两者之间存在线性剂量反应关系。炎症反应、血脂异常可能是吸烟引发冠状动脉粥样硬化的具体机制。Objective：To study the association between cigarette smoking and the severity of coronary atherosclerosis. Methods：The study population consisted of 1060 consecutive patient who underwent coronary angiography for suspected or known coronary atherosclerosis. The severity of coronary atherosclerosis was defined by Gensini＇s score .The Spearman two-way test and partial correlation analysis was used to assess the relation between two quantitative variables. The independent-sample T test was employed to investigate the distribution of the clinical data in two groups according to smoking status. Multivariate stepwise linear regression analysis was employed to explore the independent relationship between smoking and the severity of coronary atherosclerosis. Results：Spearman＇s correlation analysis indicated that smoking was positively correlated with leukocyte count, neutrophil, CH/ HDL-C, LDL-C/HDL-C and the Gensini＇s score. Leukocyte count, neutrophil, CH/HDL-C and LDL-C/HDL-C was positively correlated with the Gensini＇s score, and partial correlation analysis showed that smoking was still positively correlated with the Gensini＇s score while the age and the sex were under controlled. Independent-sample T test also found the significant differences in terms of leukocyte count, neutrophil, CH/HDL-C and LDL-C/HDL-C between the smoking group and non-smoking group. Multiple stepwise linear regression analysis demonstrated that neutrophil, smoking index and LDL-C/HDL-C significantly independently associated with Gensine＇s score. Conclusion：Smoking was independently associated with the severity of coronary atherosclerosis, as measured by Gensini＇s score. Inflammatory response and hyperlipidemia may be the mechanism involved.

关 键 词：吸烟 冠状动脉粥样硬化 GENSINI积分 

分 类 号：R181.34[医药卫生—流行病学]