飞行员吸烟量对血脂异常的影响

EFFECT OF CIGARETTE SMOKING AMOUNT ON BLOOD LIPID IN PILOTS

目的研究飞行员吸烟量对血总胆固醇(TC)、总甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白AⅠ(ApoAⅠ)、载脂蛋白B(ApoB)及冠心病发病的影响,为飞行员冠心病的防治提供依据。方法采用流行病学问卷调查表的形式,对272名飞行员(其中吸烟者169例,不吸烟者103例)吸烟史的情况进行调查,按吸烟量分为吸烟0、1、2、3级。对比分析4个等级组间血脂水平、心电图、平板运动试验及冠脉造影阳性率情况。结果35～44岁年龄组飞行员的吸烟率(58.9%)高于22～34年龄组(48.7%)和45～55岁年龄组(43.3%)。吸烟3级TC、TG、TC/HDL、LDL水平显著高于吸烟0级和1级(P<0.05),ApoB显著高于吸烟1级,HDL、ApoAⅠ显著低于吸烟0级和1级(P<0.05,P<0.01))。吸烟3级心肌缺血阳性率(30.6%)显著高于0级(14.6%)、1级(10.4%)和2级(8.0%,P<0.05)。结论吸烟是导致中青年飞行员血脂异常的危险因素之一,使心肌缺血的危险性增加;飞行员冠心病的预防重点应放在中青年吸烟等危险因素的控制上。

Objective To investigate the influence of cigarette smoking amount on the blood lipid level and the occurrence of coronary heart disease （CHD） in pilots, so as to provide the basis for CHD prevention and treatment. Methods Two hundred and seventy- two pilots （including 169 smokers and 103 nonsmokers） were selected to be investigated their smoking history by epidemiological questionnaire. They were divided into 4 groups according to the amount of cigarette smoking（0： no smoking, 1： 〈 100 cigarettes year, 2： ≥ 100 cigarettes year, 〈 200 cigarettes year, 3： 〉 200 cigarettes year）.The leve of blood lipids, incidence of abnormal ECG, positive rate of the tread mill test and coronary artery angiography （CAG） were observed. Results The percentage of smoking in pilots at the age of 35 - 44 years was 58.9 %, which was higher than the other age goups （22 - 34 years： 48.7 % ; 45 - 55 years： 43.3 % ）. The levels of TC, TG,TC/HDL-C and LDL-C were significantly higher in group 3 than in group 0 and group 1 （P 〈 0.01 ）. The level of ApoB was higher in group 3 than in group 1 （ P 〈 0.05）. The levels of HDL-C and ApoA 1 were lower in group 3 than in group 0 and group 1（ P 〈 0.05）. The positive rate of myoeardie isehemia were higher in group 3 （30.6%） than in group 0,1, and 2（ 14.6%, 10,4%, and 8.0% respectively, P 〈 0.05）. Conclusion Smoking is one of the risk factor leading to abnormality of blood lipid, and increasing the risk in cardiac isehemia. Controlling the risk factor should be regarded as the focal point of prevention of CHD in pilots.