超声检测吸烟与颅内动脉狭窄相关性的多中心研究结果分析  

Correlation between smoking and occurrence of intracranial artery stenosis by ultrasonography: an analysis of multi-center research results

作　　者：刘然[1] 华扬[1] 贾凌云[1] 邢英琦[2] 惠品晶[3] 孟璇[4] 于德林[5] 潘晓芳[6] 房亚兰[7] 宋彬彬[8] 吴春霞[9] 张春梅[10] 隋秀芳[11] 金友贺[12] 张京芬[13] 李建卫[14] 王凌[15] 穆玉明[16] 钟经馨[17] 朱榆红[18] 张恒[19] 蔡晓宇[20] Liu Ran Hua Yang Jia Lingyun Xing Yingqi Hui Pinjing Meng Xuan Yu Delin Pan Xiaof ang Fang Yalan Song Binbin Wu Chunxia Zhang Chunmei Sui X iuf ang . Zhang Jing）Cen Li Jianwei Wang Ling Mu Yuming Zhong Jingxin Zhu Yuhong Zhang Heng Cai Xiaoliu ＊(Department of Vascular Ultrasonoraph,Xuanwu Hospital, Capital Medical University.Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院血管超声科,北京100053 [2]吉林大学第一医院神经内科 [3]苏州大学附属第一医院超声科 [4]兰州大学第二医院超声科 [5]天津市环湖医院超声科 [6]大连市中心医院超声科 [7]山西医科大学第一医院超声科 [8]洛阳市中心医院神经内科 [9]山东省聊城市人民医院脑科医院超声科 [10]哈尔滨医科大学附属第一医院超声科 [11]安徽省立医院超声科 [12]中国医科大学附属第一医院超声科 [13]包头市中心医院神经内科 [14]福建省立医院超声科 [15]绵阳市中心医院超声科 [16]新疆医科大学第一附属医院超声科 [17]广东省中医院超声科 [18]昆明医科大学第二附属医院神经内科 [19]珠海市人民医院超声科 [20]湖南省脑科医院超声科

出　　处：《中国脑血管病杂志》2017年第6期297-301,312,共6页Chinese Journal of Cerebrovascular Diseases

基　　金：基金项目:国家卫生计生委脑卒中筛查与防治工程委员会[血管超声对短暂性脑缺血发作(TIA)与缺血性脑卒中住院患者颅内外动脉病变的多中心检查登记研究(201501)]

摘　　要：目的分析吸烟与颅内动脉狭窄发生的相关性。方法采用横断面研究纳入2015年6月至2016年5月,全国20家卒中防治基地因短暂性脑缺血发作(TIA)或缺血性卒中住院的患者共10 711例,排除吸烟及戒烟年限不详者76例,最终纳入10 635例患者。应用经颅彩色多普勒超声和(或)经颅多普勒超声检查评估颅内动脉狭窄病变。记录患者脑血管病基本危险因素(年龄、性别、吸烟及年限、是否戒烟及年限、高血压、糖尿病、高脂血症、心房颤动、卒中家族史)。根据患者吸烟年限不同,分为5个组:无吸烟(7 088例)、吸烟时间≤10年(293例)、11~20年(770例)、21~30年(1 185例)、>30年(1 299例)组进行趋势卡方检验。再根据吸烟者中戒烟年限不同,分为4个组:无戒烟组(2 756例)、戒烟时间1~10年(587例)、11~20年(153例)、>20年(51例)进行趋势卡方检验。分析不同吸烟年限及吸烟者不同戒烟年限对颅内动脉狭窄发生的影响。结果 (1)吸烟者颅内动脉狭窄发生率[40.4%(1 433/3 547)]显著高于无吸烟患者[29.4%(2 085/7 088)],差异有统计学意义(χ~2=128.850,P<0.01),并且吸烟者脑梗死发生率[91.6%(3 250/3 547)]显著高于无吸烟者[85.0%(6 027/7 088)],差异有统计学意义(χ~2=92.328,P<0.01)。吸烟是颅内动脉狭窄的独立危险因素(OR=1.603;95%CI:1.456~1.765;P<0.01);随着吸烟年限的增长,颅内动脉狭窄检出率逐渐升高(趋势χ~2=115.437,P<0.01);≥20年烟龄患者是否戒烟对颅内动脉狭窄的发生率无明显影响(趋势χ~2=1.043,P=0.307)。结论吸烟是影响颅内动脉狭窄的独立危险因素,患病风险随着吸烟年限的增加而上升。而长期吸烟者即使戒烟亦不能减轻对颅内动脉狭窄的影响。Objective To analyze the correlation between smoking and occurrence of intracranial artery stenosis. Methods From June 2015 to May 2016, a total of l0 711 inpatients with transient isehemie attack （TIA） or isehemie stroke from 20 basel hospitals of nationwide were enrolled using a cross- sectional study ,76 patients with unknown smoking and smoking cessation years were excluded. Finally, a total of 10 635 patients were enrolled. Transcranial color coded sonography and/or transcranial Doppler were used evaluate the intracranial artery stenosis lesions. The basic risk factors for cerebrovascular disease （ age, sex, smoking and smoking years, whether smoking cessation and years, hypertension, diabetes, hyper- lipidemia, atrial fibrillation, and family history of stroke） were recorded. According to the different smoking years,the smoking years were divided into five groups：non-smoking, smoking time ~〈 10-year, 11 to 20 - year,21 to 30-year, and 〉 30-year groups for trend chi square test. According to the different smoking cessation years in the smokers, the smoking cessation years were divided into four groups：non-cessation, cessation time 1 to 10-year, 11 to 20-year, and 〉 20-year groups for trend chi square test. The effects of different smoking years and different smoking cessation years on the occurrence of intraeranial arterial stenosis were analyzed. Results The incidence of intracranial artery stenosis in the smokers （40.4% E 1 433/ 3 547 ] ） was significantly higher than that in the non-smoking patients （29.4% E 2 085/7 088] ）. There was significant difference （X^2 = 128. 850, P 〈 0.01 ） , and the incidence of cerebral infarction in the smokers （91.6% E 3 250/3 547 ] ） was significantly higher than the non-smokers （85.0% [ 6 027/7 088 ] ）. There was significant difference （X^2 = 92. 328 ,P 〈 0.01 ）. Smoking was an independent risk factor for intracranial artery stenosis （ OR, 1. 603 ;95 % CI 1. 456 - 1. 765 ; P 〈 0.01 ）. With the increase of smoking years, t

关 键 词：脑血管疾病 颅内动脉狭窄 吸烟 经颅多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]