吸烟指数与全身动脉粥样硬化的关系研究

Relationship between Smoking Index and Systemic Atherosclerosis

背景吸烟是动脉粥样硬化的危险因素,参与动脉粥样硬化的发生、发展,亦是导致心脑血管疾病的一个重要的可改变因素,而目前有关吸烟与全身动脉粥样硬化关系的研究尚少。目的探讨吸烟指数与全身动脉粥样硬化的关系,以为吸烟人群动脉粥样硬化的预防提供理论支持。方法回顾性选取2019年1月—2020年3月于哈尔滨医科大学附属第一医院心内科、心外科住院并行冠状动脉造影术的全身动脉粥样硬化患者152例。收集患者的一般资料、血生化指标、外周动脉(颈部、双上肢肱动脉、双下肢动脉、腹部动脉)超声检查指标、冠状动脉病变支数及Gensini积分。吸烟指数与全身动脉粥样硬化患者一般资料相关性分析采用Pearson相关分析或Spearman秩相关分析;吸烟指数与全身动脉粥样硬化患者动脉硬化相关指标的关系采用Pearson相关分析或Spearman秩相关分析、多元线性回归分析或多因素Logistic回归分析。结果吸烟指数与全身动脉粥样硬化患者年龄(r=0.169)、BNP(r=0.236)、Scr(r=0.163)、颈动脉斑块分级(rs=0.268)、颈动脉狭窄程度(rs=0.175)、下肢动脉内中膜增厚(rs=0.287)、下肢动脉斑块分级(rs=0.181)、下肢动脉狭窄支数(rs=0.234)、下肢动脉狭窄程度(rs=0.204)、冠状动脉病变支数(r=0.238)呈正相关(P<0.05)。多因素Logistic回归分析结果显示,吸烟指数是全身动脉粥样硬化患者颈动脉斑块分级〔OR=1.001,95%CI(1.000,1.002)〕、下肢动脉内中膜增厚〔OR=1.001,95%CI(1.000,1.002)〕的独立影响因素(P<0.05)。结论吸烟指数可能与全身动脉粥样硬化患者颈动脉、下肢动脉、冠状动脉粥样硬化有关,且其又是颈动脉斑块分级、下肢动脉内中膜增厚的影响因素。

Background Smoking is a risk factor of atherosclerosis,which is involved in the occurrence and development of atherosclerosis,and is also an important modifiable factor leading to the occurrence of cardiovascular and cerebrovascular diseases.At present,there are few studies on the relationship between smoking and systemic atherosclerosis.Objective To discuss the relationship between smoking index and systemic atherosclerosis,in order to provide theoretical support for the prevention of atherosclerosis in smokers.Methods From January 2019 to March 2020,152 patients with systemic atherosclerosis underwent coronary angiography were selected in Department of Cardiology,Cardiac Surgery of the First Affiliated Hospital of Harbin Medical University.General information,blood biochemical index,peripheral blood vessels(arteries of neck,brachial and lower extremity arteries and abdomen)ultrasound examination indexes,number of coronary artery lesions and Gensini score were selected.Correlation between smoking index and general information in patients with systemic atherosclerosis was analysed by Pearson correlation analysis or Spearman rank correlation analysis;relationship between smoking index and systemic atherosclerosis was analysed by Pearson correlation analysis or Spearman rank correlation analysis,multiple linear regression or multivariate Logistic regression analysis.Results Smoking index was positively correlated with age(r=0.169),BNP(r=0.236),Scr(r=0.163),carotid plague grade(rs=0.268),carotid stenosis degree(rs=0.175),medial membrane of arteries of the lower extremities is thickened(rs=0.287),grade of arterial plaque in lower extremities(rs=0.181),artery stenosis of lower extremity(rs=0.234),degree of lower limb artery stenosis(rs=0.204),number of coronary artery lesions(r=0.238)in patients with systemic atherosclerosis,respectively(P<0.05).Multivariate Logistic regression analysis showed that,smoking index was an influencing factor of carotid plague grade〔OR=1.001,95%CI(1.000,1.002)〕,medial membrane of arteries of the lower extremities is thickened〔OR=1.001,95%CI(1.000,1.002)〕in patients with systemic atherosclerosis(P<0.05).Conclusion Smoking index may be related to carotid artery,lower extremity artery,coronary atherosclerosis in patients with systemic atherosclerosis,and it is an independent influencing factor of carotid plague grade,medial membrane of arteries of the lower extremities is thickened in patients with systemic atherosclerosis.