哮喘联盟

   摘要
   目的：本研究目的是探讨16年随访期间，长期的吸烟习惯、环境烟草暴露（ETS）与颈动脉内膜中层厚度（IMT）的进展率和颈动脉管腔直径减小率之间的联系。另一个目的是调查吸烟对进展率的影响是否能通过轻度炎症增加来解释。
   方法：研究人群来自MALMO饮食与肿瘤研究-心血管项目，包括2992名中年男性和女性，时间1991-1994年（基线）和2007-2012（复检）。吸烟与颈动脉IMT和由于斑块突出引起的颈动脉管腔直径减少之间的关联，通过线性回归进行了评估。
   结果：与不吸烟和无烟草暴露者相比，曾经吸烟者、中度和重度吸烟者IMT进展率和管腔直径减小率增加，即使对颈动脉分叉处IMT的最大值进行了传统危险因素校正（如每年进展率不同，毫米/年），与从不吸烟者相比，曾经吸烟者增加0.0074（95％CI：0.0018-0.0129），中度吸烟者增加0.0106（95％CI：0.0038-0.0175），而重度吸烟者增加0.0146（95％CI：0.0061-0.0230））。曾经吸烟者戒烟五年以上，发生率明显降低。吸烟者和曾经吸烟者与轻度炎症增加有关，然而，吸烟对动脉粥样硬化进展率的影响校正后保持不变。
   结论：吸烟和曾经吸烟对颈动脉IMT进展率和由于斑块突出造成管腔减小的影响无法通过传统的危险因素或轻度炎症的差异来解释。

 

（苏欣 审校）
EurJInternMed. 2015Nov5.pii:S0953-6205(15)00347-7.doi:10.1016/j.ejim.2015.10.018. [Epub ahead of print]


 

The effect of smoking on carotid intima-media thickness progression rate and rate of lumen diameter reduction.
 

Hansen K1, Östling G2, Persson M3, Nilsson PM4, Melander O5, Engström G6, Hedblad B7, Rosvall M8.
 

Abstract
OBJECTIVE:The purpose of the study was to investigate the long-term associations between smoking habits, environmental tobacco smoke exposure (ETS), carotid intima-media thickness (IMT) progression rate, and rate of lumen diameter reduction in the carotid artery during a 16-year follow-up. Another objective was to investigate if an effect of smoking on progression rate could be explained by increased low grade inflammation.
METHODS:The study population included 2992 middle-aged men and women in the 1991-1994 (baseline) and the 2007-2012 (re-examination) investigation of the Malmö Diet and Cancer Study cardiovascular cohort. Associations between smoking, progression of carotid IMT and lumen diameter reduction due to plaque protrusion were assessed by linear regression.
RESULTS:IMT progression rates and rate of lumen diameter reduction increased from never smokers with no ETS through former, moderate and heavy smokers, even after adjustment for traditional risk factors (e.g., differences in yearly progression rates (mm/year) of maximal IMT in the carotid bifurcation compared to never smokers; former smokers 0.0074 (95% CI: 0.0018-0.0129), moderate smokers 0.0106 (95% CI: 0.0038-0.0175), and heavy smokers 0.0146 (95% CI: 0.0061-0.0230)). Former smokers showed distinct lowering of progression rates after more than five years since smoking cessation. Smoking and former smoking was associated with increased low grade inflammation, however, the effect of smoking on atherosclerotic progression rate remained fairly unchanged after such adjustment.
CONCLUSION:The effect of smoking and former smoking on carotid IMT progression rates and change in lumen reduction due to plaque protrusion could not be explained by differences in traditional risk factors or low grade inflammation.
 

EurJInternMed. 2015Nov5.pii:S0953-6205(15)00347-7.doi:10.1016/j.ejim.2015.10.018. [Epub ahead of print]