吸烟与脉搏波传导速度、踝臂指数以及颈动脉硬化改变的相关性研究  

Study on the correlation of smoking with pulse wave velocity,ankle brachial index and carotid arteriosclerosis

作　　者：陈桂英[1] 郭来敬[2] 廖燕华[1] 邢敏[1] 梁娜[1] 谢焱[1] 

机构地区：[1]北京大学首钢医院古城社区卫生服务中心,北京100041 [2]北京大学首钢医院慢病研究所,北京100041

出　　处：《现代中西医结合杂志》2013年第35期3883-3885,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的前瞻性研究吸烟与颈动脉硬化改变、脉搏波传导速度(PWV)及臂踝血压指数(ABI)的相关性。方法将2 739例受检者分为吸烟组与不吸烟组,测定2组血脂、血糖、餐后血糖、体质量指数、中心动脉压、血压、PWV、ABI以及颈动脉斑块等指标,并进行相关及Logistic回归分析。结果吸烟组与不吸烟组年龄、三酰甘油、高密度脂蛋白、ABI、AIP75%、中心动脉舒张压及舒张压比较有显著性差异(P均<0.01)。吸烟组颈动脉IMT增厚、斑块形成及狭窄情况均显著高于不吸烟组(P均<0.01);而ABI、PWV吸烟组略高于不吸烟组,但无显著性差异。吸烟与颈动脉内膜增厚、颈动脉斑块及狭窄呈正相关,与ABI呈负相关,与PWV不相关。多因素回归分析显示血糖、收缩压、斑块及年龄是IMT、baPWV及ABI的独立危险因素。性别、吸烟及LDL-C也是IMT及斑块形成的独立危险因素。baPWV与ABI互为因果,但与吸烟不直接相关。结论吸烟是颈动脉硬化的独立危险因素,对于吸烟者来说,尽早进行颈动脉IMT等指标检查,可能对于早期预防和治疗动脉粥样硬化有重要意义。Objective It is to prospectively study the correlation of smoking with the pulse wave velocity （PWV） , anklebrachial index（ABI） as well as carotid arteriosclerosis changing. Methods A total of 2 739 subjects were divided into smoking group and non-smoking group, blood fat, blood sugar, BMI, central aortic pressure（CAP） , blood pressure （BP） , PWV and ABI as well as carotid plaque were determined in both groups. Results There were differences in age, TG, HDL, ABI, AIP75% , central aortic diastolic pressure and mean diastolic blood pressure between smoking group and non-smoking group（P 〈 0.01 ）. The detection rates of high carotid IMT, plaque formation and stenosis were higher in the smoking group than than in non-smoking group, the differences were significant （P 〈 0.01 ） , but there was no difference in PWV and ABI between the two groups （ P 〈 0.05 ）. There were positive correlation of smoking with carotid intimal thickening, carotid artery plaque and carotid artery stenosis, and a negatively correlation with ABI, no correlation with PWV. Multivariate regression analysis showed GLU, SBP, plaques and age were independent risk factors in IMT, baPWV and ABI. Sex, smoking and LDL - C were also independent risk factors in IMT and plaque formation, baPWV and ABI were reciprocal causation, but not directly correlated with smoking. Conclusion Smoking is an independent risk factor for carotid atherosclerosis, therefore, it may be important for smokers to determine carotid IMT as soon as possible for early prevention and treatment of atherosclerosis.

关 键 词：吸烟 脉搏传导速度 颈动脉斑块 踝臂指数 

分 类 号：R543[医药卫生—心血管疾病]