2018 年第 11 期 第 13 卷

吸烟与男性冠状动脉粥样硬化性心脏病患者血清总胆红素相关性研究

Correlation between smoking and serum total bilirubin in male patients with coronary atherosclerotic heart disease

作者：王苏张京梅张艳艳李南林运张冬花黄觊程宇彤李志忠

英文作者：

单位：100029首都医科大学附属北京安贞医院心内科十五病房（王苏、张京梅、李南、林运、张冬花、黄觊、程宇彤、李志忠），检验科（张艳艳）

英文单位：

关键词：冠状动脉疾病；吸烟；总胆红素

英文关键词：

• 摘要：

• 【摘要】目的    探讨男性冠状动脉粥样硬化性心脏病（冠心病）患者吸烟与血清总胆红素水平的相关性。方法    选取2009年1月至2012年12月于首都医科大学附属北京安贞医院确诊为冠心病并行冠状动脉介入治疗的男性患者1 902例，根据不同吸烟状态分为吸烟组（984例）、戒烟组（325例）和不吸烟组（593例）。比较3组患者一般资料和不同吸烟状态患者总胆红素水平，分析吸烟与血清总胆红素的相关性。结果    吸烟组患者血清总胆红素水平明显低于戒烟组和不吸烟组［12.20(3.34,56.90)μmol/L比13.50(3.60,49.86)、14.12(4.32,57.61)μmol/L］(均P＜0.017)，而戒烟组与不吸烟组血清总胆红素水平差异无统计学意义(P＞0.017)。将吸烟组按每日吸烟量分为3个亚组［1～10支/d亚组（166例）、11～20支/d亚组（591例）、＞20支/d亚组（227例）］，结果显示1～10支/d亚组血清总胆红素水平明显高于另两亚组(均P＜0.017)，而后两亚组血清总胆红素水平差异无统计学意义(P＞0.017)。将吸烟组按不同吸烟时间分为3个亚组［1～20年亚组（285例）、21～30年亚组（420例）、＞30年亚组（279例）］，各亚组血清总胆红素水平差异无统计学意义（P=0.683）。将戒烟组按不同戒烟时间分为2个亚组［戒烟＜2年亚组（100例）、戒烟≥2年亚组（225例）］，两亚组血清总胆红素水平差异无统计学意义（P=0.278）。Spearman秩相关分析结果显示吸烟与血清总胆红素水平呈负相关（ri＝-0.173，P＜0.001）。本研究将患者血清总胆红素水平低于10.25 μmol/L定义为低水平血清总胆红素，结果显示吸烟，每日吸烟11～20支、＞20支和吸烟时间1～20年、21～30年及＞30年均为低水平血清总胆红素发生的独立危险因素（均P＜0.05）。结论    吸烟尤其是每日吸烟量超过10支是男性冠心病患者血清总胆红素水平降低的独立危险因素，戒烟可能使总胆红素水平接近不吸烟者水平。

• 【Abstract】Objective    To investigate the correlation between smoking and serum total bilirubin in male patients with coronary atherosclerotic heart disease(CHD). Methods    From January 2009 to December 2012, 1 902 male patients diagnosed of CHD in Beijing Anzhen Hospital, Capital Medical University were divided into smoking group(n＝984), smoking cessation group(n＝325) and non-smoking group(n＝593). The relation between smoking and serum total bilirubin level was analyzed. Results    Serum total bilirubin level in smoking group was significantly lower than that in smoking cessation group and non-smoking group［12.20(3.34,56.90)μmol/L vs 13.50(3.60,49.86), 14.12(4.32,57.61)μmol/L］(both P＜0.017); there was no significant difference of total bilirubin between smoking cessation group and non-smoking group(P＞0.017). The smoking group was divided into three subgroups according to daily smoking amount: 1-10 cigarettes/d group(n＝166), 11-20 cigarettes/d group(n＝591) and ＞20 cigarettes/d group(n＝227). Serum total bilirubin level in the 1-10 cigarettes/d group was significantly higher than that in the other two groups(both P＜0.017); there was no significant difference between 11-20 cigarettes/d group and ＞20 cigarettes/d group(P＞0.017). According to smoking duration, the smoking group was divided into three subgroups: 1-20 years group(n＝285), 21-30 years group(n＝420) and ＞30 years group(n＝279)］; there was no significant difference of total bilirubin among the three groups(P=0.683). The smoking cessation group was divided into two subgroups according to quitting time:＜2 years group(n＝100) and ≥2 years group(n＝225)］; there was no significant difference of total bilirubin level between the two groups(P=0.278). Spearman rank correlation analysis showed that smoking was negatively correlated with serum total bilirubin level(ri=-0.173, P＜0.001). Smoking, 11-20 cigarettes/d, ＞20 cigarettes/d, 1-20 years, 21-30 years and ＞30 years were independent risk factors of low total bilirubin（serum total bilirubin＜10.25 μmol/L）(all P＜0.05). Conclusion    sSmoking, especially more than 10 cigarettes daily, is a risk factor of low serum total bilirubin in male patients with CHD. Quiting smoking can help increase serum total bilirubin.