一氧化碳血红蛋白测定对无戒烟意愿ACS患者烟草戒断效果

Effect of COHb measurement on tobacco cessation in ACS patients without intention to quit smoking

目的探讨动脉血一氧化碳血红蛋白测定基础上充分告知吸烟危害,对无戒烟意愿ACS患者烟草戒断效果的影响。方法2013年10月至2014年2月,连续入选心脏中心住院的不愿意戒烟的吸烟ACS患者40例,将患者随机分为一氧化碳血红蛋白(COHb)组和对照组。对照组予常规5R干预,COHb组除常规5R干预,还行动脉血COHb测定,并结合患者COHb化验回报,充分告知患者吸烟的危害。随访24周,判断两组第24周戒断率及吸烟指数差异。结果两组患者尼古丁依赖性评分分别为7.5±1.5与7.7±1.5,两组差异无统计学意义(t=-0.433,P>0.05)。COHb组患者动脉血COHb水平为(6.2±2.5)%,明显高于正常范围。随访24周时COHb组患者戒断率较对照组升高,为25%比15%,但尚未达到统计学差异(χ2=0.625,P>0.05)。COHb组患者吸烟指数较对照组显著下降。结论动脉血COHb水平检测并结合COHb升高,充分告知吸烟危害可显著降低无戒烟意愿的ACS患者吸烟指数,并在一定程度上提高戒烟率。

Objective To explore the effect of adequate harm inform based on COHb measurement on tobacco cessation in ACS patients without intention to quit smoking. Methods From 2013- 10 to 2014- 02,40 ACS patients without intention to quit smoking aged 18 to 80 were randomly divided into COHb group and control group. The control group received 5R smoking cessation measurement. The COHb levels were measured in the COHb group,in addition to 5R. The smoking cessation rate was evaluated after24 weeks. Two independent sample t test and Pearson squared test were used to compare the difference between the two groups.Results The nicotine dependence score in the COHb group and control group were 7. 5 ± 1. 5 and 7. 7 ± 1. 5 respectively,no significant difference was found in both groups,t = 0. 433,P〉 0. 05. The COHb level in COHb group was（ 6. 2 ± 2. 5） %,significantly higher than the normal range. The tobacco cessation rate in COHb group（ 25. 00%） at 24 weeks was higher than the control group（ 15. 00%）,but not yet reached statistical difference,χ2= 0. 625,P 〉0. 05. The smoking index in the COHb group was significantly reduced than in the control group,as 560 ± 270 vs 870. 5 ± 480,t = 2. 146,P 〈0. 05. Conclusion Measurement of the level of arterial blood COHb,and fully informed of the dangers of smoking could significantly reduce the smoking index of ACS patients without intention to quit smoking,and to a certain extent,could increase the smoking cessation rate.