Objective To study the relationship between smoking and plasma high-sensitivity Creactive protein,lipoprotein (a)and blood lipid levels in male patients with acute coronary syndromes (ACS).Methods A total of 181 male ACS patients were enrolled in the Department of Cardiology,PLA Wuhan General Hospital from January 2016 to January 2017,including three subgroups [66 patients with unstable angina pectoris (UAP),60 patients with acute non-ST-elevation myocardial infarction (NSTEMI),and 55 patients with acute ST-elevation myocardial infarction (STEM[)].History of smoking and alcohol consumption was collected;and levels of plasma hs-CRP,LP (a),lipids [triacylglycerol (TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C)]were measured.The differences of hs-CRP,LP (a),serum lipids were compared among the non-smoking (Group A),quit-smoking(Group B),smoking(Group C),and ACS subgroups.Results (1)There was no significant difference in age,body mass index(BMI),alcohol consumption,systolic blood pressure,fasting blood glucose and glycosylated hemoglobin between group A,B and C (all P ＞ 0.05);the levels of hs-CRP,HDL-C in group A,B and C were significantly different (all P ＜ 0.001),but there were no significant difference in the levels of LP (a),TG,TC,LDL-C (all P ＞ 0.05);there was no significant difference between coronary angiography and stent in different smoking cases (all P ＞ 0.05).(2) Subgroup analysis showed that the levels of hs-CRP between the A,B,and C groups in NSTEMI and STEMI patients were statistically significant(P ＜ 0.05 or P ＜ 0.01),and the levels of hs-CRP were increasing in NSTEMI and STEMI patients (all P ＜ 0.01).The level of HDL-C in group A,B and C was statistically significant(all P ＜ 0.01),and thelevel of HDL-C was significantly different in patients with UAP (P ＞ 0.05).There was no significant difference between UAP and NSTEMI patients(all P ＞ 0.05).Conclusions Different smoking conditions are closely related to male plasma hs-CRP,HDL-C levels in patients with ACS,regardless of LP(a),TG,TC,LDL-C levels;smoking can cause elevated hs-CRP levels and decreased HDL-C levels,and smoking cessation can greatly improve hs-CRP and HDL-C levels.%目的 研究吸烟与男性急性冠状动脉综合征(ACS)患者血浆高敏C反应蛋白(hs-CRP)、脂蛋白(a)[LP(a)]和血脂水平的关系.方法 纳入2016年1月至2017年1月中国人民解放军武汉总医院心内科收治的男性ACS患者181例,其中不稳定型心绞痛(UAP) 66例、急性非ST段抬高型心肌梗死(NSTEMI) 60例、急性ST段抬高型心肌梗死(STEMI) 55例.收集吸烟、饮酒情况并测定血浆hs-CRP、LP(a)、血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平.分析不同吸烟情况下[非吸烟组(A组)、已戒烟组(B组)、吸烟组(C组)]男性ACS患者的血浆hs-CRP、LP(a)及血脂水平差异,并进行亚组分析.结果 (1)3组间年龄、体质指数(BMI)、饮酒情况、收缩压、空腹血糖、糖化血红蛋白水平差异均无统计学意义(均为P ＞0.05);3组间hs-CRP、HDL-C水平比较,差异均有统计学意义(均为P＜0.001),而LP(a)、TG、TC和LDL-C水平比较,差异均无统计学意义(均为P＞0.05);3组间冠状动脉造影及支架情况差异无统计学意义(均为P ＞0.05);(2)亚组分析显示,在NSTEMI和STEMI患者中,3组间的hs-CRP水平差异有统计学意义(P ＜0.05或P＜0.01),且hs-CRP水平呈上升趋势,而在UAP患者中3组差异无统计学意义(均为P ＞0.05);在STEMI患者中,3组间的HDL-C水平差异有统计学意义(均为P＜0.01),且HDL-C水平呈下降趋势,而在UAP和NSTEMI患者中差异均无统计学意义(均为P＞0.05).结论 不同吸烟情况与男性ACS患者血浆hs-CRP、HDL-C水平密切相关,而与LP(a)、TG、TC、LDL-C水平无关,吸烟能导致hs-CRP水平升高,HDL-C水平降低,而戒烟能很大程度地改善hs-CRP、HDL-C水平.
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