吸烟与急性冠脉综合征患者血浆HDL-C水平之间的关系
흡연여급성관맥종합정환자혈장HDL-C수평지간적관계
The correlation analysis between smoking and the plasma HDL - C level in the patients with acute coronary syndrome
  • 万方数据
    临床和实验医学杂志 림상화실험의학잡지
    JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
    2015年 1期 29-32 ,共4页

    朱小刚%韩凌%陈立伟%赵燕%高亢%姜媛媛%杨明

    주소강%한릉%진립위%조연%고항%강원원%양명

    急性冠状动脉综合征%吸烟%血脂%高密度脂蛋白胆固醇 急性冠狀動脈綜閤徵%吸煙%血脂%高密度脂蛋白膽固醇
    급성관상동맥종합정%흡연%혈지%고밀도지단백담고순
    Acute coronary syndrome%Smoking%Blood lipid%High - density lipoprotein - cholesterol
    目的：分析急性冠脉综合征（ACS）患者吸烟状况与血浆高密度脂蛋白胆固醇（HDL - C）水平变化之间的关系。方法纳入 ACS 住院患者313例，其中不稳定型心绞痛（UA ）134例、急性非 ST 段抬高型心肌梗死（NSTEMI）81例、急性 ST 段抬高型心肌梗死（STEMI）98例，收集患者吸烟状况并测定血浆总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL - C）、高密度脂蛋白胆固醇（HDL - C）、糖化血红蛋白（HbA1c）；分析 ACS 患者不同吸烟状况[无吸烟组（A 组）、已戒烟组（B 组）、在吸烟组（C 组）]之间 HDL - C 水平的差异，并行亚组分析。结果①患者一般情况比较：ACS 患者 A、B、C 三组之间在性别构成上有统计学差异（ P =0.003），男性吸烟者比女性多；A、B、C 三组之间年龄、体重指数（BMI）、收缩压、饮酒情况、糖化血红蛋白水平无统计学差异。②ACS 患者不同吸烟状况下的血脂水平比较：A、B、C 三组之间的 TC、TG、LDL - C 无统计学差异；HDL - C 在 A、B、C 三组之间有明显统计学差异（ P ﹤0.001），而且 A 组高于 B 组（分别为1.06±0.27 vs.0.98±0.22，P ﹤0.05），A 组高于 C 组（1.06±0.27 vs.0.86±0.23，P ﹤0.001），B 组高于 C 组（0.98±0.22 vs.0.86±0.23，P ﹤0.01）。③在入选的男性 ACS 患者中，A、B、C 三组之间的 HDL - C 水平差异有明显统计学意义（ P ﹤0.001），而且 A 组高于 C 组（1.01±0.27 vs.0.84±0.22，P ﹤0.001）、B 组高于 C 组（0.95±0.22 vs.0.84±0.22，P ﹤0.05）；在女性 ACS 患者中，A、B、C 三组之间的 HDL 水平差异无统计学意义（ P =0.161），但 HDL - C 在三组间呈逐渐下降趋势。④ACS 各亚组中不同吸烟状况下的 HDL - C 水平：在 UA 患者中，A、B、C 三组之间 HDL - C 水平差异有明显统计学意义（ P ﹤0.001），而且 A 组高于 B 组（1.14±0.25 vs.1.01±0.21，P ﹤0.01）、A组高于 C 组（1.14±0.25 vs.0.78±0.16，P ﹤0.001）、B 组高于 C 组（1.01±0.21 vs.0.78±0.16，P ﹤0.001）。在NSTEMI 患者中，A、B、C 三组之间的 HDL - C 水平差异无统计学意义（ P =0.373）。在 STEMI 患者中，A、B、C 三组之间HDL - C 水平呈逐渐下降趋势，但仅 A 组与 C 组的 HDL - C 水平比较有统计学差异（1.07±0.25 vs.0.83±0.16，P ﹤0.001）。结论不同吸烟状况与 ACS 患者血浆 HDL - C 水平之间有密切关系，吸烟可导致 HDL - C 水平下降，戒烟能改善 HDL - C 水平。
    목적：분석급성관맥종합정（ACS）환자흡연상황여혈장고밀도지단백담고순（HDL - C）수평변화지간적관계。방법납입 ACS 주원환자313례，기중불은정형심교통（UA ）134례、급성비 ST 단태고형심기경사（NSTEMI）81례、급성 ST 단태고형심기경사（STEMI）98례，수집환자흡연상황병측정혈장총담고순（TC）、감유삼지（TG）、저밀도지단백담고순（LDL - C）、고밀도지단백담고순（HDL - C）、당화혈홍단백（HbA1c）；분석 ACS 환자불동흡연상황[무흡연조（A 조）、이계연조（B 조）、재흡연조（C 조）]지간 HDL - C 수평적차이，병행아조분석。결과①환자일반정황비교：ACS 환자 A、B、C 삼조지간재성별구성상유통계학차이（ P =0.003），남성흡연자비녀성다；A、B、C 삼조지간년령、체중지수（BMI）、수축압、음주정황、당화혈홍단백수평무통계학차이。②ACS 환자불동흡연상황하적혈지수평비교：A、B、C 삼조지간적 TC、TG、LDL - C 무통계학차이；HDL - C 재 A、B、C 삼조지간유명현통계학차이（ P ﹤0.001），이차 A 조고우 B 조（분별위1.06±0.27 vs.0.98±0.22，P ﹤0.05），A 조고우 C 조（1.06±0.27 vs.0.86±0.23，P ﹤0.001），B 조고우 C 조（0.98±0.22 vs.0.86±0.23，P ﹤0.01）。③재입선적남성 ACS 환자중，A、B、C 삼조지간적 HDL - C 수평차이유명현통계학의의（ P ﹤0.001），이차 A 조고우 C 조（1.01±0.27 vs.0.84±0.22，P ﹤0.001）、B 조고우 C 조（0.95±0.22 vs.0.84±0.22，P ﹤0.05）；재녀성 ACS 환자중，A、B、C 삼조지간적 HDL 수평차이무통계학의의（ P =0.161），단 HDL - C 재삼조간정축점하강추세。④ACS 각아조중불동흡연상황하적 HDL - C 수평：재 UA 환자중，A、B、C 삼조지간 HDL - C 수평차이유명현통계학의의（ P ﹤0.001），이차 A 조고우 B 조（1.14±0.25 vs.1.01±0.21，P ﹤0.01）、A조고우 C 조（1.14±0.25 vs.0.78±0.16，P ﹤0.001）、B 조고우 C 조（1.01±0.21 vs.0.78±0.16，P ﹤0.001）。재NSTEMI 환자중，A、B、C 삼조지간적 HDL - C 수평차이무통계학의의（ P =0.373）。재 STEMI 환자중，A、B、C 삼조지간HDL - C 수평정축점하강추세，단부 A 조여 C 조적 HDL - C 수평비교유통계학차이（1.07±0.25 vs.0.83±0.16，P ﹤0.001）。결론불동흡연상황여 ACS 환자혈장 HDL - C 수평지간유밀절관계，흡연가도치 HDL - C 수평하강，계연능개선 HDL - C 수평。
    Objective To analyze the relationship between smoking and plasma HDL - C level in patients with acute coronary syndrome (ACS). Methods Three hundred and thirty - three patients with ACS were selected,who were divided into three subgroups(UA 134 patients, NSTEMI 81 patients,STEMI 98 patients). The smoking history was collected and blood lipid levels including total cholesterol(TC),triglyceride (TG),low - density lipoprotein - cholesterol(LDL - C),high - density lipoprotein - cholesterol(HDL - C)were measured in all the patients. The difference in HDL - C level was compared among the non - smoking group A,stop - smoking group B and smoking group C,and among ACS subgroups. Results ①The female smokers were less significantly than the male smokers among three groups with ACS( P = 0. 003),but no sig-nificant differences in ages,BMI,systolic blood pressure,drinking and glycosylated hemoglobins(HbA1c)among group A,group B and group C ( P ﹥ 0. 05). ②The plasma HDL - C levels of group A,group B and group C were different( P ﹤ 0. 001);HDL - C level of group A was signif-icantly higher than those of group B(1. 06 ± 0. 27 vs. 0. 98 ± 0. 22,P ﹤ 0. 05),and group C(1. 06 ± 0. 27 vs. 0. 86 ± 0. 23,P ﹤ 0. 001),and it was higher in group B than that in group C(0. 98 ± 0. 22 vs. 0. 86 ± 0. 23,P ﹤ 0. 01). ③In male ACS patients,the plasma HDL - C levels of group A,group B and group C were significantly different( P ﹤ 0. 001);HDL - C levels of group A and group B were obviously higher than that of group C(1. 01 ± 0. 27 vs. 0. 84 ± 0. 22,P ﹤ 0. 001 and 0. 95 ± 0. 22 vs. 0. 84 ± 0. 22,P ﹤ 0. 05,respectively). In female ACS patients, there was no significant difference in HDL - C level among group A,group B and group C. ④There were no significant differences in HDL - C lev-el in the patients with NSTEMI among group A,group B and group C. There was significant difference in HDL - C in the patients with UA among the three groups( P ﹤ 0. 001);the HDL - C level was higher in group A than those in group B(1. 14 ± 0. 25 vs. 1. 01 ± 0. 21,P ﹤ 0. 01)and group C(1. 14 ± 0. 25 vs. 0. 78 ± 0. 16,P ﹤ 0. 001),and it was higher in group B than group C(1. 01 ± 0. 21 vs. 0. 78 ± 0. 16,P ﹤ 0. 001). For patients with STEMI,HDL - C level was decreased in all three groups,the HDL - C level was higher in group A than that in group C(1. 07 ± 0. 25 vs. 0. 83 ± 0. 16,P ﹤ 0. 001). Conclusion The plasma HDL - C levels of the patients with ACS correlates closely with different smok-ing states,furthermore,smoking could lead to reduce the plasma HDL - C level,abstaining from smoking was able to improve it.
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