本文選題：吸煙 + 葉酸��； 參考：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的探討中國農(nóng)村地區(qū)高血壓患者不同吸煙狀態(tài)對葉酸水平的影響及其可能的影響因素。方法2008年5月,在江蘇省連云港市及安徽省安慶市的農(nóng)村地區(qū)進行流行病學調(diào)查,選取45歲以上無腦卒中和心肌梗死病史的高血壓受試者,通過問卷調(diào)查的方式收集患者吸煙狀況和其他相關(guān)變量,通過化學發(fā)光免疫分析方法測定血清葉酸水平,同型半胱氨酸、空腹血糖、血脂等生化指標水平,在中國廣州南方醫(yī)院腎臟病國家臨床研究中心中心實驗室使用自動臨床分析儀(美國Beckman Coulter公司)進行測定。采用多元線性回歸模型來獲得比值比(Odds Ratio,OR)及其標準誤(Standard Error,SE),來分析吸煙與葉酸水平之間的關(guān)系。結(jié)果本研究共選取8384名男性高血壓患者,平均年齡為(61.0±7.6)歲。其中,從不吸煙者2583名,占總?cè)藬?shù)的30.8%,曾經(jīng)吸煙者1393名,占16.6%,吸煙者4408名,占52.6%。我們可以發(fā)現(xiàn)吸煙者葉酸水平最低(7.6±3.6)ng/m L,曾經(jīng)吸煙為8.1±3.7 ng/m L,不吸煙者葉酸水平為8.3±4.0ng/m L(P0.001)。同時吸煙者有更低的維生素B12含量、空腹血糖含量以及體質(zhì)量指數(shù)(P0.001)。以不吸煙組作為對照組,在調(diào)整了年齡、血壓、體質(zhì)量指數(shù)、血脂、血糖等相關(guān)影響因素后,曾經(jīng)吸煙者(β=-0.19,SE=0.12,P=0.116)葉酸水平略有下降,但不顯著,而吸煙人群(β=-0.94,SE=0.09,P0.001)葉酸水平顯著下降,并且隨著吸煙支數(shù)與吸煙年限的增加,葉酸水平下降越多。在不同的年齡分層中,吸煙均會顯著降低葉酸水平(年齡60歲,β=-0.63,SE=0.13,P0.001;年齡≥60歲,β=-1.20,SE=0.13,P0.001),而在年齡大于60歲的人群中,葉酸下降更多(交互作用P值0.001)。按不同的體質(zhì)量指數(shù)分層,低體質(zhì)量指數(shù)的人群中受吸煙的影響最大,葉酸水平顯著降低(β=-3.16,SE=0.64,P0.001),而隨著體質(zhì)量指數(shù)的逐漸增加,葉酸下降有減弱的趨勢(交互作用P值0.001)。在低同型半胱氨酸水平中,吸煙對葉酸水平影響最大(β=-1.15,SE=0.37,P=0.002)。與不吸煙不飲酒人群相比,既吸煙又飲酒人群的葉酸水平呈下降趨勢(β=-0.49,SE=0.12,P0.001)。結(jié)論本研究發(fā)現(xiàn)農(nóng)村中老年高血壓人群中吸煙狀態(tài)和葉酸水平存在負相關(guān),與從不吸煙組相比,吸煙者葉酸水平顯著降低。而在高年齡組、低體重組、低同型半胱氨酸組中葉酸下降更為明顯。因此控制吸煙、合理膳食、健康運動是提高該地區(qū)人群葉酸水平的重要措施,對中國農(nóng)村地區(qū)的心血管防治工作具有重要的公共衛(wèi)生意義。
[Abstract]:Objective to investigate the influence of smoking status on folic acid level in rural areas of China. Methods Epidemiological investigation was carried out in rural areas of Lianyungang City, Jiangsu Province and Anqing City, Anhui Province in May 2008. Hypertensive subjects aged over 45 years with no history of stroke and myocardial infarction were selected. Smoking status and other related variables were collected by questionnaire. Serum folic acid, homocysteine, fasting blood glucose, blood lipid and other biochemical indexes were measured by chemiluminescence immunoassay. Automatic clinical analyzer (Beckman Coulter) was used in the laboratory of the National Center for Clinical Research of Renal Disease in Guangzhou South Hospital, China. The multivariate linear regression model was used to obtain the ratio ratio odds ratio (OR) and its standard error (Standard Errora) to analyze the relationship between smoking and folic acid level. Results A total of 8384 male patients with hypertension were selected. The mean age was 61.0 鹵7.6 years. Of these, 2583 were non-smokers (30.8 percent of the total), 1393 were former smokers (16.6 percent), and 4408 were smokers (52.6 percent). It was found that the lowest folic acid level was 7.6 鹵3.6)ng/m / L in smokers, 8.1 鹵3.7 ng/m / L in smokers and 8.3 鹵4.0ng/m / L in nonsmokers (P 0.001). Smokers also had lower levels of vitamin B 12, fasting blood glucose and body mass index (P 0.001). After adjusting the related factors such as age, blood pressure, body mass index, blood lipid and blood sugar, the folic acid level of former smokers (尾 -0.19) decreased slightly, but not significantly, while the level of folic acid in smoking population (尾 -0.94Se 0.09P 0.001) decreased significantly. And with the increase of smoking number and smoking years, folic acid level decreased more. In different age stratification, smoking significantly decreased folic acid levels (age 60, 尾 -0.63Se 0.13P 0.001; age 鈮，

本文編號：1785252