吸烟量与冠心病关系的病例对照研究

陆丕能; 孙宁玲; 陆鋆; 卢明喻

Abstract

陆丕能,孙宁玲,陆鋆,卢明喻.吸烟量与冠心病关系的病例对照研究[J].Chinese journal of Epidemiology,2002,23(4):297-300

吸烟量与冠心病关系的病例对照研究

Case control study on the association of coronary artery disease and cigarette smoking

Received:November 19, 2001 Revised:June 18, 2012

DOI：

KeyWord: 冠状动脉疾病吸烟心绞痛,不稳定型病例对照研究

English Key Word: Coronary artery disease Cigarette smoking Angina unstable Case control study

FundProject:

Author Name	Affiliation
Lu Peineng	Department of Cardiology, People's Hospital, Peking University, Beijing 100044, China
Sun Ningling	Department of Cardiology, People's Hospital, Peking University, Beijing 100044, China
Lu Jun	广西南宁地区医院心内科
Lu Mingyu	Department of Cardiology, People's Hospital, Peking University, Beijing 100044, China

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Abstract:

目的确定吸烟量与冠心病的关系。方法355例行冠状动脉造影的患者(A组,无冠心病患者142例;B组,冠心病患者213例),以性别、年龄、体重指数、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、纤维蛋白原、吸烟量等级、冠心病家族史、高血压病等多重危险因素以及冠状动脉严重程度评分进行多变量分析。结果单因素分析,冠心病的OR值95%可信区间(CI):吸烟与不吸烟比较为1.629～2.598,P <0.05;吸烟3级时与不吸烟比较为1.260～3.907,P <0.01。多元logistic回归分析显示:吸烟等级、性别、纤维蛋白原、空腹血糖与冠心病相关 ,年龄与冠心病基本相关。各吸烟级别分别进行多元logistic回归分析显示:与不吸烟组比较,吸烟 1级时与冠心病无关(OR =0.948,P=0.959),吸烟3级的冠心病风险OR为3.519(P=0.003,95%CI:1.538～ 8.053);吸烟2级以上(2+3级)与2级以下(0+1)比较,OR为2.094 (P=0.027),3级与3级以下(0+1+2)比较OR为3.463(P=0.002)。以上病例分为3组:对照组、稳定型心绞痛组和不稳定型心绞痛组。用多维logistic回归分析显示,与不稳定型心绞痛比较,稳定型心绞痛组吸烟对患不稳定型心绞痛的风险OR。

English Abstract:

Objective To determine the association of cigarette smoking and coronary artery diseases (CAD). Methods A case control study involving 355 people classified as CAD or without CAD was performed. But people treated with diuretic,aspirin, lipid lowering agents, heparin or those with renal, hepatic diseases were excluded. Gender, age, body mass index, plasma glucose under fasting, total cholesterol,triglyceride,high density lipoprotein cholesterol, low density lipoprotein cholesterol, fibrinogen, cigarette smoking consumption grade (0:no smoking,1:less or equal 100 cigarette year,2:one hundred cigarette year cigarette index≤200 cigarettes year,3:greater than 200 cigarette year), CAD family history, essential hypertension and CAD severity were analyzed. Results In multiple logistic regression, age, gender, fasting plasma glucose, fibrinogen and cigarette smoking showed significant independent association with CAD. Compared with non smoker, the odds ratio ( OR ) of CAD of grade 3 cigarette smoking was 3.519 (95% CI : 1.538 8.053 , P = 0.003 ). However with grade 1 cigarette smoking group, no significant independent association was found with CAD ( OR = 0.948 , P = 0.959 ). With more than grade 2 [grade 2+3, compared with less than grade 2(0+1)] and grade 3 [compared with less than grade 3 (0+1+2)] cigarette smoking, ORs of CAD were 2.094 ( P = 0.027 ), 3.463 ( P = 0.002 ) respectively.Three handred fifty five people were divided into 3 groups: control, stable angina (SA) and unstable angina (UA) groups. In multinomial logistic regression, when comparing with UA, parameter estimate of cigarette smoking degree in the SA group were β= -0.220 , s = 0.138 , P = 0.112 , OR = 0.803 respertively. Conclutions Cigarette smoking was a significant independent risk factor for CAD. With more cigarettes smoked,a higher odds ratio of CAD was seen. Gender, age,fibrinogen and plasma glucose during fasting were also independent factors significantly associated with CAD. No significant independent association between cigarette smoking and unstable angina was found.

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