吸烟对血管内皮舒张功能及内源性血管活性肽的影响

Effect of smoking on endothelium-dependent vascular relaxing function and plasma apelin level

目的探讨吸烟对血管内皮舒张功能及内源性血管活性肽apelin-13的影响。方法2014年12月1日至2015年4月30日采用随机数字表法选取健康志愿者40人，按照是否吸烟分为吸烟组与非吸烟组（各20人），吸烟组给予戒烟干预1个月，非吸烟组给予短时吸烟干预，比较吸烟组与非吸烟组之间及两组干预前后血管内皮舒张功能及内源性apelin-13的变化。结果吸烟组血流介导的舒张功能（FMD）较非吸烟组显著降低[（5．34±1．83）％比（8．12±2．62）％，t=-3．75，P〈0．01]，戒烟干预1个月后FMD明显升高[（5．34±1．83）％比（9．05±2．18）％，t=-6．66，P〈0．01]，非吸烟组短时吸烟干预后FMD稍有降低[（8．12±2．62）％比（7．78±1．96）％，t=0．90，P=0．38]，差异无统计学意义。吸烟组血浆apelin-13水平较非吸烟组显著降低[（44．22±16．58）pg／ml比（70．12±24．35）pg／ml，t=-3．79，P〈0．01]，吸烟组戒烟干预1个月后血浆apelin-13水平明显升高[（44．22±16．58）pg／ml比（65．32±17．13）pg／ml，t=-4．26，P〈0．01]，非吸烟组予短时吸烟干预后血浆apelin-13水平明显降低[（70．12±24．35）pg／ml比（45．83±15．66）pg／ml，t=4．93，P〈0．01]。结论健康吸烟者存在血管内皮功能障碍，即使短期阻断烟草的摄入，也可显著改善血管内皮功能，这一过程伴随血浆apelin-13水平的改变，提示apelin-13可能参与吸烟导致的内皮功能障碍的发生、发展。

Objective To explore the effect of smoking on endothelium-dependent vascular relaxing function and endogenous apelin-13 level. Methods Forty healthy volunteers, including 20 smokers and 20 non-smokers were randomly selected and participated in the study from December 2014 to April 2015. During the study period the smokers were asked to quit smoking for one month and the non-smoking group was given short-term smoking intervention. The changes of vascular endothelial function and plasma apelin- 13 levels were compared between the smoking group and non-smoking group, and before and after intervention. Results Flow-mediated dilatation （FMD） in smoking group was significantly lower than that in non-smoking group [（5.34±1.83）% vs. （8.12±2.62）%, t= -3.75,P〈0.01]. FMDin smoking group was significantly increased after 1 month of quitting smoking [ （ 5. 34 ±1. 83 ） % vs. （ 9.05 ±2. 18 ） %, t = - 6.66, P 〈 0.01 ], FMD in non smoking group was slightly decreased [ （8.12 ±2.62 ） % vs. （7.78 ±1.96） % ,t = 0.90,P = 0. 38 ] after short-term smoking. The level of plasma apelin-13 in smoking group was significantly lower than that of non smoking group [ （44. 22 ±16. 58 ）pg/ml vs. （70. 12 ±24.35 ） pg/ml, t = -3.79 ,P 〈 0.01 ]. The level of plasma apelin-13 in smoking group was significantly increased after 1 month of smoking cessation intervention [ （44.22 ±16.58 ） pg/ml vs. （ 65.32 ±17. 13 ） pg/ml, t = - 4. 26, P 〈 0. 01 ]. In non smoking group, the level of plasma apelin-13 was significantly decreased after short-term smoking [（70. 12 ±24. 35）pg/ml vs. （45. 83 ±15.66） pg/ml,t =4.93,P 〈0.01]. Conclusion Cigarette smoking leads to endothelial dysfunction. Short term occlusion of tobacco may significantly improve endothelial function and increase plasma apelin-13 level, suggesting that apelin-13 may be involved in the occurrence and development of endothelial dysfunction induced by cigarette smoking.