吸烟环境对急性心肌梗死患者的危害及作用机制  

作　　者：魏科华[1] 姜兴千[2] 

机构地区：[1]锦州市中心医院心内科,辽宁121000 [2]辽宁医学院附属第一医院神经内科

出　　处：《当代医学》2016年第3期3-5,共3页Contemporary Medicine

摘　　要：目的探讨吸烟环境对急性心肌梗死患者的危害及作用机制。方法选择确诊急性心肌梗死患者200例,年龄35-65岁,按接受香烟刺激情况分为身处吸烟环境组和无吸烟环境组（本文吸烟环境指患者本人吸烟或患者被动吸烟,或经常接触被香烟熏过的物品,如吸烟者的衣物等,上述三种情况即现在人们常说的一手烟,二手烟,三手烟;无吸烟环境组指周围无上述3种情况）。吸烟环境组136例,其中再分为一手烟组39例,二手烟组58例,三手烟组39例,其余为非吸烟环境组64例。比较心肌梗死后各相关化验指标的水平差异及半年后比较4组患者再住院率,心肌梗死再发率,猝死率,心衰发病率及心衰分级。结果吸烟环境组较无吸烟环境组心肌梗死再发率,猝死率,心衰发病率及心衰分级均高,测得内皮祖细胞（EPCs）水平明显降低,非吸烟环境组（0.101±0.026）%,与一手烟组（0.043±0.026）%,二手烟组（0.045±0.023）%,三手烟组（0.048±0.022）%相比,差异有统计学意义（P〈0.001）,并且炎症指标,血脂、心肌酶水平明显升高,差异有统计学意义（P〈0.001）。结论吸烟环境,无论一手烟,二手烟,三手烟均为影响急性心肌梗死患者病情的危险因素,且是影响急性心肌梗死患者预后的独立危险因素。Objective To study the harm of smoking environment on patients with acute myocardial infarction （mi） and mechanism of action. Methods Confirmed 200 cases of patients with acute myocardial infarction （mi）, aged 35 to 65 years old, according to the accept cigarettes stimulus into in smoking group and non smoking environment groups （note this environment refers to the patient himself smoking or passive smoking patients, or often contact items in the cigarettes smoked, such as the smoker＇s clothing, etc, the above three conditions that people often say that now one hand smoke, secondhand smoke, third-hand smoke; no smoking group refers to the surrounding environment and the above three conditions）. Comparison after myocardial infarction level difference of the related laboratory index and four patients after six months in hospital admission rates, recurrence rate of myocardial infarction, sudden death rate, incidence of heart failure and heart failure. Results Smoking environment less smoking environment group recurrence rate of myocardial infarction, sudden death rate, high incidence of heart failure and heart failure classification, measured endothelial progenitor cells （EPCs） significantly lower levels,Non smoking environment group （0.101±0.026）%, （0.043±0.026）% in one hand.Secondhand smoke group （0.045±0.023）%, Three hand smoke group（0.048±0.022）% , The difference was statistically significant （P〈0.001）, and inflammation, blood fat, myocardial enzyme levels increased significantly, with significant difference （P〈0.001）. Conclusion Smoking environment, regardless of the hand smoke, cigarette smoke, third-hand smoke are the risk factors influencing the patients of acute myocardial infarction, and are independent risk factors affecting the prognosis of patients with acute myocardial infarction.

关 键 词：急性心肌梗死 吸烟环境 内皮祖细胞 

分 类 号：R542.22[医药卫生—心血管疾病]