华东地区625名农村男性居民吸烟和颈动脉斑块的关系

The association between smoking status and carotid artery plaque in rural areas of Eastern part of China

目的探讨在我国华东地区农村居民吸烟状态和颈动脉斑块的关系。方法于2013年7-9月，在安徽省安庆市和江苏连云港4个县（区）的农村地区开展流行病学调查，以乡为单位按整群筛查方法抽取40岁以上的健康的中老年男性，进行体格检查、问卷调查以及应用多普勒超声测量颈动脉斑块形成，比较从不吸烟者、曾经吸烟者、现在吸烟者3组间颈动脉斑块形成的发生率。采用logistic回归分析吸烟对颈动脉斑块影响。结果本试验纳入625名男性进行分析。现在吸烟者占51．4％（321名），曾经吸烟者占21．3％（133名），不吸烟者占27．4％（171名）。32．0％（200／625）的受检者有颈动脉斑块。现在吸烟者中斑块形成发生率（35．2％，113／321）高于从不吸烟者（23．4％，40／171）（x^2=7．26，P=0．007），曾经吸烟者中斑块发生率（35．3％，47／133）也高于从不吸烟者（23．4％，40／171）（x^2=5．23，P=0．022）。多因素logistic回归分析显示，在校正年龄、收缩压、舒张压、BMI、血糖、TC、TG、HDL-C、饮酒、地区差异后，现在吸烟者颈动脉斑块形成的危险较从不吸烟者高（OR=1．84，95％CI：1．13～2．98）；与≤60岁且不吸烟组（8％，3／40）比较，〉70岁且吸烟组的斑块发生率（55％，31／56）较高，高龄且吸烟组斑块形成的风险有明显的联合作用（OR=8．06，95％CI：2．07～31．45）。结论华东地区农村中老年男性人群中吸烟者颈动脉斑块发生率较高。

Objective To investigate the correlation between smoking status and carotid plaque in rural population residing in Eastern part of China. Methods Between July and September of 2013, an epidemiological survey was carried out in residents aged 40 or above men who were enrolled randomly in rural areas of Anqing, Anhui province and Lianyungang, Jiangsu province. The data on epidemiologieal characteristics including smoking status, physical examination were collected using standardized protocol, and carotid uhrasonography was applied to examine the incidence of carotid plaque among never smokers, former smokers and current smokers. Logistic regress analysis was performed to determine the effect of smoking on carotid plaque. Results In the study, a total of 625 male participants were included in the study. 51.4% （321 cases） were current smokers, 21.3% （133 cases） were former smokers, and 27.4% （171 cases） were never smokers. 32. 0% （200/625） had carotid plaque. The incidence of carotid plaques was significantly higher in current smokers （35.2% , 113/321 ） than that in never smokers （23.4%, 40/ 171 ） （ X^2 = 7.26,P = 0. 007 ） and the incidence in former smokers （ 35.3 %, 47/133 ） was also higher than that in never smokers （ 23.4% , 40/171 ） （ X^2 = 5.23, P = 0. 022 ） . Multiple logistic regression analysis showed that current cigarette smoking is significantly associated with the increased risk of carotid plaque （0R=1.84,95% CI： 1.13 - 2. 98,P =0.014） in comparison with never smokers, and there was aninteraction between current smoking and age in association with carotid plaque. Compared with the young（ ≤60 years old）and never smoking group （8%, 3/40）, prevalence of carotid plaque among the elderly （ 〉 70 years old） and smoking group（55% ,31/56） was significantly higher（ OR = 8.06, 95% CI：2. 07 - 31.45） after adjusting for age, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride high-density lipoprotein, body mass index, drinking and regional differences. Conclusion It found that cigarette smoking was associated with increased risk of carotid plaque in rural elderly population residing in Eastern part of China.