吸烟对早期血管病变的影响及戒烟的干预作用

Impact of smoking on early arterial stiffness and the intervention of smoking cessation

目的探讨吸烟对早期血管病变的影响及戒烟后不同时间段血管病变的改善程度。方法随机选择不同中青年人群495例[(平均年龄39±6)岁],吸烟组186例(≥5支/d,持续≥1年),不吸烟组157例(从不吸烟),戒烟组152例(停止吸烟至少1个月),戒烟组又分三组,戒烟<1年,1年≤戒烟<10,戒烟≥10年。室温下测定肱动脉一踝动脉脉搏波传导速度(ba PWV)、踝臂指数(ABI)、颈动脉内膜中层厚度(CIMT)、流量介导的肱动脉扩张(FMD),计算体重指数(BMI),测量肱动脉血压,标准方法检测总胆固醇、高密度脂蛋白、甘油三脂、血糖、肌酐。结果⑴吸烟组的ba PWV及CIMT分别为1503.65±18.45及0.92±0.26,较不吸烟组明显增加(分别为1168.54±13.57及0.72±0.12),差异有统计学意义(P<0.05),吸烟组的ABI及FMD分别为0.86±0.12及9.73±1.26,较不吸烟组明显降低(分别为1.15±0.65及13.32±1.34),差异有统计学意义(P<0.05);⑵即使戒烟后,在一定时期内,戒烟组ba PWV较不吸烟组仍增加;⑶戒烟10年以上组的ba PWV与从不吸烟者ba PWV相比,两者无明显差异(1162.37±9.10 vs 1168.54±13.57,P>0.05)。结论⑴吸烟可引起动脉礓硬度增加,ba PWV升高;⑵戒烟可以改善动脉硬化,但戒烟10年以上才能达到从不吸烟的水平。

Objective To study influence of smoking on early vascular disease and the improvement after smoking cessation. Methods These 495 young and middle-aged persons aged 33±6 years old, on average ,were divided into three groups ：Smoking group （〉5 cigarettes per day and 〉1 year）,no smoking group,smoking cessation group （stop smoking at lest one month）. The three groups contained 186,157,152 cases separately. The smoking cessation group were divided into three subgroups according to smoking cessation time,which shows as follows： 〈1 year, 1 to 10 years, ≥ 10 years. These index were observed：baPWV,ABI, CIMT, FMD, BMI, BP ,TC, HDL-C ,TG ,Glu and Cr. Result baPWV and CIMT of smoking group increased significantly compared with the no smoking group （1503.65±18.45 vs 1168.54±13.57,0.92±0.26 vs 0.72±0.12,P〈0.05）. whereas ABI and FMD were lower in smoking group compared with nonsmokers （0.86±0.12 vs 1.15±0.65,9.73±1.26 vs 13.32±1.34,P〈0.05）. 3.baPWV of people giving up smoking for at lest 10 years had no difference with those in no smoking group （1162.37≥9.10 vs 1168.54±13.57,P〉0. 05）. Conclusion （1）Smoking could decrease the compliance and increase the baPWV of vascular in a short time. （2）Giving up smoking could improve the compliance of vascular,and even reach the level of no smoking group if giving up for 10 year.