儿童青少年室内公共场所二手烟暴露与颈动脉内中膜厚度的关系  

Association between secondhand smoke exposure in indoor public places and carotid intima-media thickness in children and adolescents

作　　者：马传伟 李成 孙嘉鸿 赵敏 席波 MA Chuanwei;LI Cheng;SUN Jiahong;ZHAO Min;XI Bo(Department of Epidemiology,School of Public Health,Cheeloo College of Medicine,Shandong University/Children Cardiovascular Research Center of Shandong University,Ji'nan(250012),China;不详)

机构地区：[1]山东大学齐鲁医学院公共卫生学院流行病学系/山东大学儿童心血管研究中心,济南250012 [2]广东医科大学公共卫生学院流行病与卫生统计学系 [3]江苏医药职业学院公共卫生与管理学院 [4]山东大学齐鲁医学院公共卫生学院毒理与营养学系

出　　处：《中国学校卫生》2023年第10期1450-1453,共4页Chinese Journal of School Health

基　　金：国家自然科学基金项目(81673195)。

摘　　要：目的 探讨儿童青少年室内公共场所二手烟暴露与颈动脉内中膜厚度(cIMT)的关系,为儿童青少年心血管结构异常的早期防控提供依据。方法 数据来源于2021年11—12月进行的“儿童心血管健康随访队列”第二次随访调查。共纳入1 297名具有完整信息(包括性别、年龄、cIMT、体测指标、问卷调查指标及血生化指标)的儿童青少年用于统计分析。采用线性回归分析评估儿童青少年cIMT水平随室内公共场所二手烟暴露天数的变化趋势。调整各种潜在协变量,采用多元线性回归模型分析室内公共场所二手烟暴露天数与cIMT的关系。结果 在过去1周内,儿童青少年自我报告在室内公共场所暴露于二手烟1~2 d的有407(31.4%)名、3~4 d的有86(6.6%)名、≥5 d的有82(6.3%)名。随着室内公共场所二手烟暴露天数的增加,不同模型下儿童青少年cIMT呈上升趋势(t值分别为3.30,3.05,2.87,P值均<0.05);在调整各种协变量后,儿童青少年cIMT值分别为[0 d/周:(551.5±29.3)μm, 1~2 d/周:(554.0±28.6)μm, 3~4 d/周:(557.0±27.7)μm,≥5 d/周:(559.4±27.5)μm]。与过去7 d未在室内公共场所暴露于二手烟的儿童青少年相比,至少5 d暴露于二手烟的儿童青少年存在cIMT增厚的风险(β=7.91,95%CI=1.47~14.34,P<0.05)。结论 儿童青少年室内公共场所二手烟暴露率仍处于较高水平且与cIMT存在较强关联。应采取更严格的控烟措施为儿童青少年提供良好的无烟环境,以降低心血管早期结构异常的发生风险。Objective To examine the association between secondhand smoke exposure(SHS)in indoor public places and carotid intima-media thickness(cIMT)in children and adolescents,so as to provide guidance for the prevention of early abnormal vascular architecture.Methods The data were obtained from the second follow-up of the Children Cardiovascular Health Cohort Study conducted from November to December 2021.A total of 1297 children and adolescents for who completed data relating to sex,age,cIMT,physical examinations,questionnaires variables and blood biochemical indices,were included for analysis.Linear regression analysis was performed to examine trends in the levels of cIMT with exposure to SHS in indoor public places.Multiple linear regression analysis was carried out to assess the association between SHS exposure in indoor public places and cIMT after adjustment for potential covariates.Results During the previous 7 days,407(31.4%)children and adolescents were exposed to SHS in indoor public places for 1-2 days,86(6.6%)for 3-4 days,and 82(6.3%)for≥5 days.The levels of cIMT in youth increased on different models,with the duration of SHS exposure during the previous 7 days(t=3.30,3.05,2.87,P<0.05).After adjusting for various covariates,the cIMT values of children and adolescents were[0 day:(551.5±29.3)μm,1-2 days:(554.0±28.6)μm,3-4 days:(557.0±27.7)μm,≥5 days:(559.4±27.5)μm].Compared to those who were not exposed to SHS in indoor public places during the previous 7 days,those exposed for≥5 days had significantly higher cIMT levels(β=7.91,95%CI=1.47-14.34,P<0.05).Conclusion Among children and adolescents,exposure to SHS in indoor public places remains high and is significantly associated with cIMT.The findings highlight the need for stricter regulation and tobacco control policies to provide healthy smoke-free environments for children and adolescents,and to reduce the risk of early abnormal vascular architecture.

关 键 词：烟草烟污染 颈动脉 回归分析 儿童 青少年 

分 类 号：F768.29[经济管理—产业经济] R179[医药卫生—妇幼卫生保健] R714.252[医药卫生—公共卫生与预防医学]