酒石酸伐尼克兰戒烟对血管内皮功能的影响

Effect of smoking cessation with varenicline on endothelial function

关键词:  动脉粥样硬化  血管内皮功能  戒烟  酒石酸伐尼克兰

Key words:  atherosclerosis  endothelial function  smoking cessation  varenicline

摘要:

［目的］探讨应用酒石酸伐尼克兰戒烟对血管内皮功能的影响。［方法］将113名健康吸烟男性随机分为酒石酸伐尼克兰戒烟组36名，单纯咨询戒烟组42名，不戒烟组35名，另选49名健康不吸烟男性作为对照组，临床随访12周，监测4周持续戒烟率；应用高分辨率超声测定12周前后健康吸烟者与对照者肱动脉血流介导的血管舒张功能（FMD）及内皮非依赖性血管舒张功能（EID）。 ［结果］（1）酒石酸伐尼克兰戒烟组第9~12周4周持续戒烟率高于单纯咨询戒烟组（72%，48%，P<0.05）。（2）健康吸烟者的FMD较对照者降低［（6.5±2.8）%，（17.1±3.7）%，P<0.05］，二者的EID差异无显著性意义。（3）12周后戒烟成功组FMD得到改善［（6.7±2.9）%，（15.6±3.5）%，P<0.05］，戒烟失败及不戒烟组FMD无改善［（6.4±3.6）%，（7.2±2.6）%，P>0.05；（6.6±3.2）%，（6.7±2.6）%，P>0.05］；12周后各组EID差异无显著性意义。（4）酒石酸伐尼克兰戒烟组与单纯咨询戒烟组成功者FMD均较戒烟前明显改善，但前者优于后者 ［（17.5±4.0）%，（13.7±2.8）%，P=0.037］。（5）12周末酒石酸伐尼克兰戒烟组与单纯咨询戒烟组失败者FMD均较戒烟前无改善（P>0.05），且二者之间差异无显著性意义（P>0.05）。 ［结论］吸烟者早期即有血管内皮功能障碍，酒石酸伐尼克兰是一种较为安全有效的戒烟药物，应用该药物戒烟成功者血管内皮功能改善较明显。

Abstract:

［Objective］To investigate the effect of smoking cessation with varenicline on vascular endothelial function.［Methods］One hundred and thirteen healthy smoking men were randomly divided into 3 groups:thirty-six subjects smoking cessation with varenicline, forty-two subjects smoking cessation with consultation,thirty-five subjects without smoking cessation. Forty-nine nonsmokers were enrolled as control group. The 4-week continuous quit rates were monitored by the exhaled carbon monoxide. Flow-mediated dilatation (FMD) and endothelium-independent dilatation (EID) of brachial artery were measured with high-resolution ultrasonography before and after 12 weeks.［Results］ (1) From the week 9 to 12, the 4-week continuous quit rate was 72% for varenicline vs 48% for consultation (P<0.05) groups. (2) FMD was significantly reduced in smokers compared with nonsmokers ［(17.1±3.7)% vs (6.5±2.8)%, P<0.05］, whereas EIDs were identical in both groups ［(15.2±3.2)%, (15.8±2.7)%, P>0.05］. (3) After 12 weeks,FMD of smoking cessation success, smoking cessation failures, and non-smoking cessation group were ［(6.7±2.9)%, (15.6±3.5)%, P<0.05］;［(6.4±3.6)%, (7.2±2.6)%, P>0.05］;［(6.6±3.2)%, (6.7±2.6)%, P> 0.05］respectively, indicating improved endothelial function in successful smoking cessation and no improved endothelial function in smoking cessation failure and non-smoking cessation group. Whereas EIDs were identical in four groups. (4) In the end of 12th week, successful abstinence's FMD was (17.5±4.0)% for varenicline, (13.7±2.8)% for consultation (P=0.037). (5) At the end of 12th week,unsuccessful abstinence's FMD was (7.5±3.0)% for varenicline, (7.0±2.8)% for consultation (P>0.05).［Conclusion］Healthy smoker has endothelial dysfunction early.Varenicline is a kind of safe and efficacious smoking cessation drug, improving endothelial function in cessation progress.