吸烟对慢性心力衰竭患者血浆NT-proBNP水平的影响

发布时间：2018-05-12 14:57

本文选题：吸烟 + 慢性心力衰竭　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:本研究拟探讨吸烟与慢性心力衰竭患者血浆N末端B型脑钠肽(NT-pro BNP)水平的相关性,以及其他临床因素与血浆NT-pro BNP水平的关系。方法:收集山西省人民医院心内科二病区住院的113例慢性心力衰竭患者,记录研究对象的年龄、性别、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、心功能级别、基础疾病史、吸烟和饮酒状况等一般项目以及检测空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血肌酐(Scr)、血尿素氮(BUN)、血红蛋白(Hb)、NT-pro BNP等生化指标。按照吸烟状况将研究对象分为吸烟组、戒烟组以及非吸烟组,对三组间一般项目及生化指标进行比较,采用多元线性回归分析年龄、性别、吸烟状况、饮酒状况、BMI、FPG、TG、TC、HDL-c、LDL-c、SBP、DBP、心功能级别、基础疾病史与血浆NT-pro BNP水平的关系。结果:(1)以吸烟组、戒烟组、非吸烟组为不同暴露组,三组在血浆NT-pro BNP的表达水平上,差异显著,具有统计学意义(P0.05),且经两两比较差异均有统计学意义(P0.05),吸烟组NT-pro BNP水平较戒烟组和非吸烟组显著升高,且戒烟组高于非吸烟组。比较三组患者BMI、HDL-c、ALT、AST、Scr、BUN、WBC、Hb、Plt、SBP、DBP、心功能级别,差异无统计学意义(P0.05),但比较年龄、性别、FPG、TC、TG、LDL-c,三组差异有统计学意义(P0.05),且经两两比较,差异均有统计学意义(P0.05)。(2)以年龄、性别、吸烟状况、饮酒状况、BMI、FPG、TG、TC、HDL-c、LDL-c、SBP、DBP、心功能级别、基础疾病史作为自变量,血浆NT-pro BNP水平作为因变量,进行多元线性回归分析,结果显示与血浆NT-pro BNP水平相关的因素为吸烟状况、年龄、心肌病(P0.05)。结论:(1)吸烟是引起血浆NT-pro BNP水平升高的重要危险因素。(2)吸烟组患者较非吸烟组患者心衰发病年龄平均提前15年。(3)与NT-pro BNP水平相关的其他因素为年龄、心肌病。(4)NT-pro BNP水平随年龄增加而升高,但吸烟组患者年龄较戒烟组及非吸烟组偏低,而NT-pro BNP水平反而偏高,很可能吸烟加重心衰严重程度。
[Abstract]:Aim: to investigate the relationship between smoking and plasma N-terminal B-type brain natriuretic peptide (NT-pro) BNPs in patients with chronic heart failure, and the relationship between other clinical factors and plasma NT-pro BNP levels. Methods: 113 patients with chronic heart failure (CHF) in the second ward of cardiology of Shanxi Provincial people's Hospital were collected. The subjects' age, sex, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiac function grade, history of basic diseases were recorded. General items, such as smoking and drinking status, and the detection of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-c), alanine aminotransferase (alt), aspartate aminotransferase (AST), etc. Serum creatinine (SCR), blood urea nitrogen (bun), hemoglobin (HB) and NT-pro BNP, etc. According to the smoking status, the subjects were divided into smoking group, smoking cessation group and non-smoking group. The general items and biochemical indexes were compared among the three groups. Age, sex, smoking status and drinking status were analyzed by multiple linear regression analysis. The relationship between the history of basic diseases and plasma NT-pro BNP level. Results (1) there were significant differences in plasma NT-pro BNP expression among smoking group, smoking cessation group and non-smoking group. The NT-pro BNP level of smoking group was significantly higher than that of smoking cessation group and non-smoking group, and the level of NT-pro BNP in smoking group was higher than that in non-smoking group. There was no significant difference in heart function grade, but age, sex, TGG, LDL-c, and the difference between the three groups were statistically significant (P 0.05), and the difference was significant in age, sex, smoking status, and the difference was significant in two groups (P < 0.05), but the difference was significant in age, sex, smoking status, age, sex, TGN, LDL-c, and the difference between the three groups was statistically significant (P0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05). Alcohol consumption status was determined by multivariate linear regression analysis. The results showed that smoking status, age, cardiomyopathy P0.05 were the main factors related to the drinking status of BMI-FPGG, HDL-cCU LDL-cU, cardiac function, history of basic disease as independent variable, plasma NT-pro BNP level as dependent variable. The results showed that the factors related to plasma NT-pro BNP level were smoking status, age, and cardiomyopathy P0.05. the results showed that the risk factors associated with NT-pro BNP level were smoking status, age, and cardiomyopathy P0.05. Conclusion smoking is an important risk factor for the increase of plasma NT-pro BNP level. (2) the mean age of onset of heart failure in smoking group is 15 years earlier than that in non-smoking group. Other factors associated with NT-pro BNP level are age. The level of NT-pro BNP in cardiomyopathy increased with the increase of age, but the age of smoking group was lower than that of smoking cessation group and non-smoking group, but the level of NT-pro BNP was higher than that of non-smoking group, which may aggravate the severity of heart failure by smoking.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6

【参考文献】