吸烟及其相关因素对中国男性单纯吸烟人群颈总动脉弹性影响的研究  

Effect of Smoking and Its Related Factors on Chinese Male Pure Smokers' Common Carotid Artery Elasticity

作　　者：马琳 阚艳敏 李治安[2] 郭瑞君[3] 肖丹[4] 黄品同[5] 

机构地区：[1]华北理工大学附属医院超声科,河北省唐山市063000 [2]首都医科大学附属北京安贞医院超声诊断科,北京市100029 [3]北京朝阳医院超声医学科,北京市100020 [4]北京朝阳医院呼吸内科,北京市100020 [5]浙江大学医学院附属第二医院超声科,浙江省杭州市310058

出　　处：《中国全科医学》2017年第6期661-667,672,共8页Chinese General Practice

摘　　要：背景吸烟是引起动脉硬化的主要危险因素,动脉弹性减低是动脉硬化的早期改变,分析吸烟及其相关危险因素对动脉弹性的影响有重要意义。血管回声跟踪(ET)技术可以在血管发生明显的形态学改变之前检测到动脉弹性的减低。目的探讨吸烟及其相关因素对中国男性单纯吸烟人群颈总动脉(CCA)弹性的影响。方法 2009年8月—2011年8月从全国各地46所医院的国人吸烟人群调查数据中,选取符合纳入标准的男性单纯吸烟者915例为吸烟组。同时选取国人正常值手册中的1 920例中国男性正常人群为正常组。记录两组年龄,吸烟组吸烟相关因素,即平均每日吸烟量、吸烟年数、开始吸烟年龄、尼古丁依赖程度评分。记录吸烟组左右侧CCA的内膜中膜厚度(IMT),两组CCA的弹性参数[硬度指数(β)、弹性系数(Ep)、顺应性(AC)、膨大指数(AI)及脉搏波传导速度(PWVβ)]。结果吸烟组左、右侧CCA的β、Ep、PWVβ均大于正常组,AC、AI均小于正常组(P<0.05);吸烟组20~29岁、30~39岁、40~49岁、50~59岁、≥60岁左、右侧CCA的β大于正常组(P<0.05)。吸烟组10~19岁左侧CCA,20~29岁、30~39岁、40~49岁、50~59岁、≥60岁左、右侧CCA的Ep大于正常组(P<0.05)。吸烟组20~29岁、≥60岁左、右侧CCA,30~39岁左侧CCA,50~59岁右侧CCA的AC小于正常组(P<0.05)。吸烟组10~19岁、20~29岁左、右侧CCA,30~39岁、50~59岁右侧CCA的AI小于正常组(P<0.05)。吸烟组10~19岁、≥60岁右侧CCA,20~29岁左、右侧CCA,30~39岁、40~49岁左侧CCA的PWVβ大于正常组(P<0.05)。吸烟组平均每日吸烟量与CCA的IMT、β、Ep、PWVβ呈正相关,与CCA的AC呈负相关(P<0.05);吸烟年数、开始吸烟年龄、尼古丁依赖程度评分与CCA的IMT、β、Ep、AI、PWVβ呈正相关,与CCA的AC呈负相关(P<0.05)。多元逐步线性回归分析结果显示,平均每日吸烟量、吸烟年数是CCA的IMT的影响因素(P<0.05);平均每日吸烟量、吸烟年数、�Background Smoking is one of the main risk factors for atherosclerosis and the decrease of arterial elasticity is the early change,so it is important to analyze the effect of smoking and its related risk factors on arterial elasticity. Echo - tracking（ET）technique can detect the decrease of arterial elasticity before the apparent morphological changes of the blood vessels. Objective To explore the effect of smoking and its related factors to Chinese male pure smokers＆#39; common carotid artery（CCA）elasticity. Methods From the survey data of Chinese pure smokers from 46 hospitals in China,915 male pure smokers who met the inclusion criteria were selected as the smoking group from August 2009 to August 2011. During the same period,1 920 healthy Chinese men without history of smoking were selected as the normal group from the Chinese people＆#39;s normal manual. The data of age,elasticity parameters of CCA〔arterial wall stiffness index（ β）,pressure - strain elasticity modulus （Ep）,arterial compliance（AC）,augmentation index（AI）and pulse wave velocity（PWVβ）〕of both groups,and smoking- related factors（average daily cigarette consumption,smoking years,age of smoking initiation,nicotine dependence score）, intima media thickness（IMT）of left and right CCA of the smoking group were recorded. Results In the smoking group,β, Ep,PWVβ of left and right CCA were significantly higher while AC and AI were lower than those in the normal group（ P ﹤0. 05）. The β of left and right CCA in age groups of 20 - 29,30 - 39,40 - 49,50 - 59 and ≥60 in the smoking group was higher than that in the normal group（P ﹤ 0. 05）. Ep of left CCA in 10 - 19 age group,and Ep of left and right CCA in age groups of 20 - 29,30 - 39,40 - 49,50 - 59 and ≥60 in the smoking group were higher than those in the normal group（P ﹤0. 05）. AC of left and right CCA in age groups of 20 - 29 and ≥60,AC of left CCA in age group of 30 - 39,AC of right CCA in age group of 50 - 59 in the smoking group we

关 键 词：颈总动脉 弹性 吸烟 男人 中国 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学]