血清可替宁水平与冠心病的关系

目的研究血清可替宁水平与冠心病的关系,探讨其在冠心病中的临床应用价值。方法按冠状动脉造影结果将149例研究对象分为冠心病组(97例)和非冠心病对照组(52例),进行病例对照研究,同位素稀释串联质谱法(isotope dilution tandem mass spectrometry,ID-LC/MS/MS)测定血清可替宁浓度,分析可替宁与冠心病及其他危险因素的关系。结果 149例行冠状动脉造影患者血清可替宁浓度呈偏态和尖态分布(偏度2.90,峰度7.96),吸烟者的可替宁浓度为12.64(0.91～99.61)μg/L,显著高于非吸烟者0.22(0.12～0.51)μg/L,P<0.001]。高可替宁水平组(>10.00μg/L)患冠心病的风险显著高于低可替宁水平组(<1.00μg/L)(OR=2.94,95%CI:1.11～7.78,P<0.05);且随着血清可替宁水平的升高,OR值增大呈量效关系(均为P<0.05)。多因素Logistic回归分析显示,糖尿病、血脂异常及可替宁为最显著的危险因素(均为P<0.05)。血清可替宁与吸烟(r=0.656,P<0.001)和白细胞计数(WBC,r=0.257,P=0.010)呈显著正相关,与HDL-C(r=-0.184,P=0.025)和HDL2-C(r=-0.217,P=0.008)呈显著负相关。结论血清可替宁水平能够有效地反映吸烟的暴露水平,其水平升高能够增加患冠心病的危险。

Association between serum cotinine and coronary artery disease

Objective To assess the association between serum cotinine and coronary artery disease(CAD). Methods A total of 149 hospitalized patients underwent coronary angiography were included.Patients were divided into CAD group(n=97) and non CAD control group(n=52) according to coronary angiogram.Serum cotinine concentrations were determined by isotope dilution tandem mass spectrometry(ID-LC/MS/MS). Results Serum cotinine levels of 149 subjects were shown skewed and leptokurtic distribution.Cotinine levels of smokers were significantly higher than non-smokers 12.64(0.91-99.61) μg/L vs.0.22(0.12-0.51) μg/L,P<0.001].CAD risk in the highest cotinine level group(>10 μg/L) was significantly higher than in the lowest group(<1 μg/L),the OR value was 2.94(95% CI: 1.11-7.78,P<0.05).With the increment of serum cotinine level,OR increased in parallel with dose-effect relationship(all P<0.05).Multifactor logistic regression analysis showed that diabetes,dyslipidemia and cotinine were the most marked risk factors(all P<0.05).Cotinine level was positively correlated with smoking(r=0.656,P<0.001) and white blood cell counts(WBC,r=0.257,P=0.010),and negatively correlated with HDL-C(r=-0.184,P=0.025) and HDL2-C(r=-0.217,P=0.008). Conclusions Serum cotinine can effectively reflect smoking exposure,and the increased serum level of cotinine is associated with the development of CAD.