【圖文】戒煙與心血管病防治最佳策略

1、 戒煙是冠心病強(qiáng)效干預(yù)措施 阿司匹林 冠心病死亡率下降（%） 0 10 20 30 40 15% 23% 23% 29% 36% ACEI b阻滯劑 他汀類藥物 戒煙* * 研究為一項(xiàng)Meta分析，收入2003年前發(fā)表的20項(xiàng)在冠心病人 群中評(píng)估戒煙影響的前瞻性研究。 1. Critchley JA, et al. Mortality risk reduction associated with smoking cessation in patients with coronary heart disease: a systematic review. JAMA; 2003; 290: 86-

2、97. 2. Pignone M, et al. Use of lipid lowering drugs for primary prevention of coronary heart disease: meta-analysis of randomised trials. BMJ. 2000; 321:983-986.3. Freemantle N, et al. beta Blockade after myocardial infarction: systematic review and meta regression analysis. BMJ. 1999;318:1730-1737

3、. 4. Flather MD, et al. Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients: ACE-Inhibitor Myocardial Infarction Collaborative Group. Lancet. 2000;355:1575-1581. 5. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002;324:71-86. 探本溯源，回歸臨床 戒煙愈早，心血管臨床獲益愈大 隨著心血管防御重心前移，防治吸煙所帶來(lái)的心血管危害也必須相應(yīng) 地前移至亞臨床階段，如軟終點(diǎn)、病理機(jī)制等。 吸煙對(duì)動(dòng)脈粥樣硬化斑塊起始、進(jìn)展等各階段產(chǎn)生廣泛影響，而內(nèi)皮 損傷是介導(dǎo)吸煙致動(dòng)脈粥樣硬化發(fā)生