吸煙與心血管疾病

1、 中國NEHNS IV (中國心血管疾病危險因素現(xiàn)狀IV) 和吸煙相關的死亡的前三位疾病：和吸煙相關的死亡的前三位疾?。簢赓Y料為：國外資料為：COPDCOPD冠心病冠心病肺癌肺癌國內資料為：國內資料為：COPDCOPD肺癌冠心病肺癌冠心病1. Surgeoen Generals Report. Health Consequences of Smoking; 2004. 2. J Natl Cancer Inst. 1993;85(24):1994. 2 3. Crane. Cancer Epidemiol Biomarkers Prev. 1996;5(8):639. -11 4. Mili

2、gi. Am J Ind Med. 1999;36(1):60. 5. Roman. Cerebrovasc Dis, 2005;20(Suppl 2):91-8. 6. Willigendael. J Vasc Surg. 2004;40:1158. -107. Yang. BMJ. 1999;319:143-9Lavi et al. Circulation. 2007;115:2621-2627-6; /HIC/Topics/Diag/diangio.cfm. Accessed June 14, 2007.右冠狀動脈粥樣硬化

3、右冠狀動脈粥樣硬化Sambola et al. Circulation. 2003;107:973-977-5.Factor Xa (FXa) pmol/L/minP=.0032172830100200300400吸煙者吸煙前（2支煙）吸煙者吸煙2h后(2支煙)Barua et al. Circulation. 2001;104:1905-1910.50000NonsmokersN=8Current SmokersN=154000300020001000NO Concentration (nmol/L)P.000112663613Lavi et al. Circulation. 2007;11

4、5:2621-2627.Endothelial Dysfunction (%)P=.03604530150NonsmokersEx-smokersCurrentSmokersN=11546%34%35%N=766Waters et al. Circulation. 1996;94:614-621.-7 已有病變加重的發(fā)生率已有病變加重的發(fā)生率吸煙者N=90非吸煙者N=240P=.002患者百分率新病變發(fā)生率新病變發(fā)生率吸煙者P=.007非吸煙者患者百分率F/U2 YearsaThe ratio of the odds of development of disease in exposed p

5、ersons to the odds of development of disease in nonexposed persons.Teo. Lancet. 2006;368:647-658.-12OR (95% CI)a109876543210年齡年齡407070非吸煙者戒煙者吸煙20支/天吸煙1-19支/天Yusuf S et al . Lancet. 2004;364:937-52-13a The probability of an event (developing a disease) occurring in exposed people compared with the pr

6、obability of the event in nonexposed people. Adjusted for age.Willett et al. N Engl J Med. 1987;317(21):1303-1309.吸煙者每日吸煙量吸煙者每日吸煙量相對風險可信區(qū)間95aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for ag

7、e.Wannamethee et al. Circulation. 1995;91:1749-1756.1.02.30.01.02.03.04.0不吸煙者吸煙者相對風險可信區(qū)間95aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age, follow-up period, history of diabetes, hyperten

8、sion, high cholesterol levels, and relative weight (in 5 categories).Colditz et al. N Engl J Med. 1988;318(15):937-941.1-1415-24不吸煙者25吸煙者每日吸煙量（支）吸煙者每日吸煙量（支）相對風險可信區(qū)間95aTwenty-year age-adjusted mortality per 10,000 person-years for men. P.014 for trend. Hart et al. Stroke. 1999;30:1999-2007.15-241-152

9、5吸煙者每日吸煙量（支）吸煙者每日吸煙量（支）死亡率/10000人*年Freund KM, The Framingham Study: 34 years of follow-up. Ann Epidemiol 1993; 3:417-424Witteman JC,. Circulation 1993; 88:2156-2162-15Wilmink TB, J Vasc Surg 1999; 30:1099-1105-141. CDC. Surgeon General Report 2004 -22. American Cancer Society. Guide to Quitting Smok

10、ing2006-1 肺功能改善減少咳嗽鼻竇充血呼吸急促等 3 3個月個月肺Ca發(fā)生率是繼續(xù)吸煙者的30-50% CAD危險減少50%CAD危險與正常不吸煙者相似卒中危險恢復到正常不吸煙者水平1 1年年5 5 年年10 10 年年15 15 年年戒煙戒煙aThe ratio of the odds of development of disease in exposed persons to the odds of development of disease in nonexposed persons. Adjusted for sex, region, diet, alcohol, phys

11、ical activity, consumption of fruits, vegetables, and alcohol.Adapted from Teo. Lancet. 2006;368:647-658.-12比值比可信區(qū)間95 aAbstention period of 3 years. Hallstrom et al. N Engl J Med. 1986;314:271-275.3年內發(fā)生率年內發(fā)生率 (%)P=.038心臟驟停反復發(fā)作心臟驟停反復發(fā)作2719051015202530吸煙者戒煙者aN=310aThe probability of an event (developi

12、ng a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age and treatment assignment.Robbins et al. Ann Intern Med. 1994;120(6):458-462.-16不吸煙者戒煙者吸煙者(20支/日)吸煙者(20 支/日）P .0001(趨勢趨勢)相對風險可信區(qū)間95Jonason et al. Acta Med Scand. 1987;221:253-260.年年累積靜息痛累積靜息痛 (