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被动吸烟对不吸烟女性血脂和血液流变学指标的影响
引用本文:何耀,姜斌,万志恒,郑强荪,李兰荪,李良寿.被动吸烟对不吸烟女性血脂和血液流变学指标的影响[J].中华流行病学杂志,2007,28(12):1167-1170.
作者姓名:何耀  姜斌  万志恒  郑强荪  李兰荪  李良寿
作者单位:1. 解放军总医院老年医学研究所,北京,100853
2. 解放军总医院针灸科,北京,100853
3. 第四军医大学
基金项目:教育部留学回国人员科研启动基金 
摘    要:目的 在不吸烟女性中探讨被动吸烟对血脂、纤维蛋白原和血液黏度的影响.方法 在115例冠心病患者(其中52例经冠脉造影确诊)和208名非冠心病者为对照组(83名经冠脉造影排除)中采用国际标准的质控血清进行血脂组分,即血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及亚组分HDL2-C、载脂蛋白(apo)A1和apoB、纤维蛋白原和血液黏度的测定.被动吸烟暴露的定义是与吸烟的丈夫或同事接触至少5年.结果 在冠脉造影确诊者中被动吸烟者的血脂紊乱、血浆纤维蛋白原水平和血浆黏度的升高较非被动吸烟史者更为严重,且与冠脉病变程度呈正相关.在非冠心病对照组中,127例被动吸烟者与81例非被动吸烟暴露者各变量的调整(年龄、体重指数、既往病史)均值的差异检验P值分别为:TC 0.06、TG 0.30、HDL-C 0.004、HDL2-C<0.001、apoA1<0.001、apoB 0.009、apoB/apoA1<0.001、纤维蛋白原<0.001、血浆<0.001及全血的低高两个切变率黏度<0.001和0.004.被动吸烟量与HDL-C、HDL2-C、apoA1、apoB、apoB/apoA1、纤维蛋白原、血浆及全血的高低两个切变率黏度的多元相关系数分别为-0.25、-0.27、-0.30、0.24、0.31、0.32、0.43、0.51和0.36(P值均<0.01).结论 无论生理或病理状态下,被动吸烟均可导致机体脂代谢紊乱、血浆纤维蛋白原和血液黏度的升高.

关 键 词:吸烟  血脂  纤维蛋白原  冠心病
收稿时间:2007/6/28 0:00:00

Study on the relationship between passive smoking and blood lipids, fibrinogen and viscosity among women who never smoke
HE Yao,JIANG Bin,WAN Zhi-heng,ZHENG Qiang-sun,LI Lan-sun and LI Liang-shou.Study on the relationship between passive smoking and blood lipids, fibrinogen and viscosity among women who never smoke[J].Chinese Journal of Epidemiology,2007,28(12):1167-1170.
Authors:HE Yao  JIANG Bin  WAN Zhi-heng  ZHENG Qiang-sun  LI Lan-sun and LI Liang-shou
Institution:Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Abstract:OBJECTIVE: To determine whether blood lipids profile, fibrinogen and viscosity were associated with passive smoking (i. e. environmental tobacco smoke, ETS) in Chinese women who never smoke. METHODS: In Xi'an, China, a case-control study was carried out on 115 cases of coronary heart disease (CHD) defined by coronary arteriography (CAG) and 208 non-CHD controls confirmed by CAG and/or exercise electrocardiography. Data on exposure to ETS, defined as exposure from cigarettes smoking husband or co-workers or both for at least 5 years, was obtained through standardized interviews. Standard laboratory methods were used and the lipid measurements were under US CDC quality control programs. RESULTS: In the subjects defined by CAG, the levels of high density lipoprotein cholesterol (HDL-C), HDL2C, apolipoprotein (apo) A1 among passive smokers appeared lower than those in non-passive smokers,but the low density lipoprotein cholesterol (LDL-C), apoB, apoB/A1, fibrinogen, plasma and whole blood viscosity were higher than that in non-passive smokers. There were positive associations of the numbers of coronary arteriosclerosis with the levels of blood lipids,fibrinogen and viscosity. In the non-CHD controls, 81 subjects were not exposed and 127 were exposed to ETS. The P values of t-test for the adjusted (for age, body mass index, present diseases history) means between two groups were listed below: 0.06 (total cholesterol), 0.30 (triglyceride), 0.004 (HDL-C), <0.001 (HDL2-C), < 0.001 (apoA1), 0.009 (apoB), <0.001 (apoB/apoA1), <0.001 (fibrinogen), <0.001 (plasma viscosity), <0.001 and 0.004 two measures (5.75/s and 230/s) of whole blood viscosity]. The correlation coefficients between cumulative exposure of passive smoking and HDL-C,HDL2-C,apoA1, apoB, apoB/apoA1, fibrinogen, plasma viscosity, and two measures of whole blood viscosity were -0.25, -0.27, -0.30, 0.24, 0.31, 0.32, 0.43, 0.51 and 0.36 (all P<0.01), respectively. CONCLUSION: Passive smoking could affect blood lipid metabolism, fibrinogen and viscosity in the never smoking women which might contribute to the causation of coronary heart disease.
Keywords:Passive smoking  Blood lipids  Fibrinogen  Coronary heart disease
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