青年吸烟冠心病患者冠状动脉病变特点和控烟干预  

Coronary characteristics of young smokers with coronary heart disease and the effects of tobacco control on smoking cessation

作　　者：赵菁[1] 胡大一[1] 丁荣晶[1] 李学斌[1] 张萍[1] 王龙[1] 俞晓军[2] 郭继鸿[1] 王晓青[1] 李蕾[1] 张菲斐[3] 黄振文[3] 

机构地区：[1]北京大学人民医院心脏中心, 100044 [2]浙江省舟山市人民医院心内科 [3]郑州大学第一附属医院心内科

出　　处：《中华心血管病杂志》2010年第12期1077-1080,共4页Chinese Journal of Cardiology

摘　　要：目的 分析青年吸烟冠心病患者冠状动脉病变特点,并探讨人为干预对控烟的影响.方法 入选确诊为冠心病的青年患者160例（14～35岁）,将吸烟患者118例和非吸烟患者42例均分为心理辅导组和对照组.通过冠状动脉造影分析患者的冠状动脉病变特点,并调查出院后3个月患者的吸烟情况.结果 与非吸烟患者比较,吸烟患者单支病变的比例较低（50.84%比66.67%,P＜0.01）,急性冠状动脉综合征（75.42%比50.00%,P＜0.05）、双支病变（24.58%比19.05%,P＜0.05）、三支病变（11.86%比4.47%,P＜0.05）、冠状动脉瘤样扩张（12.71%比9.52%,P＜0.01）的比例和Gensini积分（61.94±40.35比45.08±28.97,P＜0.05）较高.在3个月的随访期中,吸烟患者心理辅导组的戒烟率高于对照组（61.76%比30.00%,P＜0.05）;非吸烟患者心理辅导组的新发吸烟率低于对照组（0比5.00%,P＜0.05）.结论 青年吸烟冠心病患者的冠状动脉病变程度重于非吸烟患者.人为干预有助于控烟.Objective Coronary features of young smokers and non-smokers with coronary heart disease were compared and the effect of tobacco control education was analyzed. Methods A total of 160 young patients （14-35 years old ） diagnosed with coronary heart disease by coronary angiography were included in this study, patients were followed up for 3 months. There were 118 smokers and 42 nonsmokers, smokers were further divided to psychological counseling intervention group （68 cases） and control group （50 cases ）, non-smokers were also divided into psychological counseling intervention group （22 cases） and control group （ 20 cases）. Results Incidence of single-vessel lesion （50. 84% vs. 66. 67% ）was significantly lower, acute coronary syndrome （75.42% vs. 50. 00% ）, double-vessel lesions （24. 58%vs. 19. 05% ）, three-vessel lesions （ 11.86% vs. 4. 74% ） as well as coronary artery ectasias （ 12.71%vs. 9. 52% ） was significantly higher in smokers than in non-smokers. Gensini scores （61.94 ±40. 35 vs.45.08 ± 28.97 ） was significantly higher in smokers than in non-smokers （ all P 〈 0. 05 ）. At the end 3-months follow up, smoking cessation rate was significantly higher in psychological counseling intervention group than in control group （61.76% vs. 30. 00%, P 〈 0. 05 ）. New smokers was zero in psychological counseling intervention group and 1 in control group among previou non-smokers. Conclusion Smoking is linked with severe coronary artery lesion in young patients with coronary heart disease and psychological counseling intervention could significantly increase the short-term successful smoking cessation rate in these patients.

关 键 词：冠状动脉疾病 戒烟 冠状血管造影 

分 类 号：R686[医药卫生—骨科学]