吸烟伤肺更心.ppt

烟草和烟雾的主要成分研究 刺激物 慢性阻塞性呼吸道疾病 一氧化碳 心血管疾病 尼古丁 致成瘾，不致癌 2 1 Rockville, MD:Reducing the health consequences of smoking: 25 years of progress. A report of the Surgeon General.US Department of Health and Human Services, 1989； 2 Waldum et al.:Long-term effect of inhaled nicotine. Life Sciences 1996;58:1339-1346 焦油 肿瘤 吸烟促发心血管疾病的发病机理 内皮功能紊乱 血栓生成增加 炎症反应加强 氧化修饰 Lavi et al. Circulation. 2007;115:2621-2627; /HIC/Topics/Diag/diangio.cfm. Accessed June 14, 2007. 右冠状动脉粥样硬化 吸烟使心血管疾病雪上加霜！ 吸烟使冠心病的风险倍增 a All rates were age-adjusted by 10-year age groups to the US white male population in 1980. Hypercholesterolemia defined as cholesterol ?250 mg/dL. Hypertension defined as a diastolic blood pressure ?90 mm Hg. Burns. Prog Cardiovasc Dis. 2003;46(1): 11-29; Source: Pooling Project Research Group, 1978. A+B或A+C 进入研究之初危险因素情况 B+C A+B+C A、B、C任一项 无危险因素 冠心病发生率 /1000人 A：吸烟 B：胆固醇升高 C：高血压 主动脉粥样硬化的风险随吸烟量增加 aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age, systolic blood pressure, serum total cholesterol, Quetelet index, diabetes mellitus, menopausal status, alcohol consumption, use of replacement estrogens, and duration of follow-up.Witteman et al. Circulation. 1993;88(part 1):2156-2162. 不吸烟者 1 至 9 10 至 19 ?20 吸烟者每日吸烟量（支） 相对风险 可信区间 95％ 冠心病死亡率的增加与吸烟率直接相关 a The probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age.Willett et al. N Engl J Med. 1987;317(21):1303-1309. 致死冠心病的相对风险 1-14/日 非吸烟者 15-24/日 ?25/日 吸烟者每日吸烟量 相对风险 可信区间 95％ 吸烟增加心源性猝死的风险 aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age.Wannamethee et al. Circulation. 1995;91:1749-1756. 1.0 2.3 0.0 1.0 2.0 3.0 4.0 不吸烟者 吸烟者 相对风险 可信区间 95％ 吸烟使冠状动脉介入治疗后发生Q波心梗的风险增高 aThe probability of an event (developing a dis