吸烟的冠心病患者戒烟现状及影响因素分析  

Status quo and factors influencing smoking cessation in cigarette smoking patients with coronary artery disease

作　　者：罗太阳[1] 雷涛[1] 刘小慧[1] 彭雪梅 康俊萍[1] 吕强[1] 王海云[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029 [2]北京房山医院心内科

出　　处：《中华心血管病杂志》2011年第5期406-409,共4页Chinese Journal of Cardiology

摘　　要：目的 了解吸烟的冠心病患者对于吸烟问题的认识及戒烟状况,揭示戒烟及戒烟未成功的原因和影响因素,为更有效地帮助冠心病患者控烟提供参考.方法 对350例吸烟的冠心病患者进行问卷调查,包括性别、年龄、吸烟史等,采用分组分析、logistic回归分析等方法分析戒烟的影响因素.结果 350例吸烟的冠心病患者平均年龄（59.6±10.2）岁,男321例（占91.7%）.57.1%（200/350）的患者已戒烟,42.9%（150/350）的患者目前仍在吸烟.将患者按年龄分两组,非老年组患者（≤65岁,n=239）戒烟率50.6%,显著低于老年组患者（〉65岁,n=111）的71.2%（P〈0.001）.非老年组有戒烟意愿及尝试过戒烟的比例分别为70.3%和48.3%,均低于老年组的81.2%和59.4%（P〈0.001）.76例戒烟复吸者中,复吸最主要原因为缺乏自我控制能力,占76.3%.logistic回归分析,影响戒烟未成功的因素：年龄≤65岁（OR=2.336,P=0.004）、文化程度低（OR=1.310,P=0.028）、行经皮冠状动脉介入治疗术（OR=0.261,P〈0.001）、行冠状动脉旁路移植术（OR=0.107,P=0.004）、家庭总收入〉4000 元/月（OR=1.828,P=0.003）.结论 吸烟的冠心病患者戒烟水平和意识仍有待提高;除现有的控烟政策外,应更加关注中青年、文化程度较低、未行经皮冠状动脉介入治疗及冠状动脉旁路移植术、家人有人吸烟、体质指数及家庭总收入越高的吸烟冠心病患者的控烟活动;在针对吸烟冠心病患者控烟活动的同时对其周围环境宣传控烟活动也是迫切需要的.Objective To investigate the status quo of smoking cessation and analyze factors influencing smoking cessation in cigarette smoking patients with coronary artery disease（CAD）.Method A total of 350 smoking patients with CAD was surveyed by questionnaire,logistic regression analysis was performed to analyze factors influencing smoking cessation.Results Incidence of smoking cessation was 57.1%（200/350）in this cohort.Patients were divided into two groups,the elderlv（〉65 years old,n=111）and the young group（≤65 years old,n=239）.The smoking cessation rate in the elderlv group is significantly higher than in the young group（71.2%vs.50.6%,P〈0.001）.Aged patients and patients with high cultural level are easier to give up smoking.Logistic analysis showed that age≤65 years old （OR=2.336,P=0.004）,low cultural level（OR=1.310,P=0.028）,PCI（OR=0.261.P〈0.001）.coronary artery bypass graft（OR=0.107,P=0.004）,total family income〉4000 RMB/month （OR=1.828,P=0.003）are risk factors for failed smoking cessation.There are 76 patients smoking again in current smokers,most due to lack of self-control（76.3%）.Compared to the elderly group,there is a higher proportion of smoking again due to the need of daily communication and work in the young group.Conclusions We still need to raise the awareness of smoking cessation for smoking patients with CAD.Following factors should be focused for tobacco control in CAD patients：younger age,lower cuItural level,not treated with PCI or CABG,patients with smoking family members.higher body mass index and higher total family income.

关 键 词：冠状动脉疾病 吸烟 戒烟 

分 类 号：R541.4[医药卫生—心血管疾病]