戒烟对呼吸、心血管系统及其他生理学影响
2009/05/20
背景：戒烟与烟草相关的患病率和死亡率下降有关。基于目前的文献，戒烟的有益影响主要是对肺和心血管功能，但戒烟对机体生理学的负面影响较少研究。
范围：本文系统综述了戒烟的生理学影响。文献基于临床试验、随机对照试验和meta分析，这些文献通过其标题和摘要于MEDLINE （2003年5月～2008年5月）检索获得。其他研究通过综述文献的目录获得。
研究发现：戒烟与肺功能的改善和呼吸道症状发生率及严重程度的下降有关。这些变化在戒烟的最初几个月内比较明显，而且能在长期戒烟中得到维持。对于曾经吸烟的健康人，吸烟诱导的气道炎症和内皮功能异常等潜在的病理生理学在戒烟后部分得到逆转，但对慢性阻塞性肺病患者则未见上述变化。戒烟也能引起心血管功能的显著改善，且能减少原发性和继发性心血管疾病的患病率和死亡率。虽然戒烟对健康的长期有益作用毫无疑问，但戒烟对机体生理学还存在其他不希望看到的短期不良影响：体重增加、高血压、便秘和口腔溃疡，以及导致代谢多种常用药物的酶——细胞色素P450 1A2（CYP1A2）酶活性改变。
结论：戒烟对机体生理学的负面影响将干扰吸烟者的戒烟意愿，医生在宣传戒烟对机体正面影响的同时，应该给予吸烟患者戒烟的动力，对患者经常鼓励和支持。此外，既然吸烟是CYP1A2的潜在激动剂，对于戒烟患者，若服用需该酶代谢的药物时，使用剂量需密切监测。
（林江涛 审校）
Gratziou C. Curr Med Res Opin. 2009 Feb;25(2):535-545.
Respiratory, cardiovascular and other physiological consequences of smoking cessation.
BACKGROUND: Smoking cessation is associated with substantial reductions in tobacco-related morbidity and mortality. Based on the current literature, the beneficial effects of quitting are particularly evident on pulmonary and cardiovascular function, but the negative physiological effects of cessation are less well documented. SCOPE: The objective of this article was to review systematically data on the physiological effects of smoking cessation. Articles based upon clinical trials, randomised controlled trials and meta-analyses were selected from titles and abstracts obtained via a MEDLINE search (May 2003-May 2008). Additional studies were identified from the bibliographies of reviewed literature.
FINDINGS: Smoking cessation is associated with improved lung function and a reduction in the presence and severity of respiratory symptoms. These changes, apparent within months of quitting, are sustained with long-term abstinence. The underlying pathophysiologies of smoking-induced airway inflammation and endothelial dysfunction are partially reversed following cessation in healthy ex-smokers, but not in those with chronic obstructive pulmonary disease. Smoking cessation is also associated with substantially improved cardiovascular function and reduced risk of primary and secondary cardiovascular morbidity and mortality. Although the overall long-term health benefits are unquestionable, smoking cessation is also associated with other possible undesirable short-term physiological effects such as weight gain, hypertension, constipation and mouth ulcers; and altered activity of the enzyme cytochrome P450 1A2 (CYP1A2), which metabolises many commonly used drugs.
CONCLUSION: The negative physiological effects of smoking cessation may adversely affect a smoker’s attempt to quit, and physicians should provide their smoking patients with motivation and regular encouragement and support when attempting to quit, whilst educating them on the health benefits of abstinence. Additionally, since cigarette smoke is a potent inducer of CYP1A2, patients attempting to quit smoking should have their dosages of drugs metabolised by this enzyme closely monitored.
Gratziou C. Curr Med Res Opin. 2009 Feb;25(2):535-45.
范围：本文系统综述了戒烟的生理学影响。文献基于临床试验、随机对照试验和meta分析，这些文献通过其标题和摘要于MEDLINE （2003年5月～2008年5月）检索获得。其他研究通过综述文献的目录获得。
研究发现：戒烟与肺功能的改善和呼吸道症状发生率及严重程度的下降有关。这些变化在戒烟的最初几个月内比较明显，而且能在长期戒烟中得到维持。对于曾经吸烟的健康人，吸烟诱导的气道炎症和内皮功能异常等潜在的病理生理学在戒烟后部分得到逆转，但对慢性阻塞性肺病患者则未见上述变化。戒烟也能引起心血管功能的显著改善，且能减少原发性和继发性心血管疾病的患病率和死亡率。虽然戒烟对健康的长期有益作用毫无疑问，但戒烟对机体生理学还存在其他不希望看到的短期不良影响：体重增加、高血压、便秘和口腔溃疡，以及导致代谢多种常用药物的酶——细胞色素P450 1A2（CYP1A2）酶活性改变。
结论：戒烟对机体生理学的负面影响将干扰吸烟者的戒烟意愿，医生在宣传戒烟对机体正面影响的同时，应该给予吸烟患者戒烟的动力，对患者经常鼓励和支持。此外，既然吸烟是CYP1A2的潜在激动剂，对于戒烟患者，若服用需该酶代谢的药物时，使用剂量需密切监测。
（林江涛 审校）
Gratziou C. Curr Med Res Opin. 2009 Feb;25(2):535-545.
Respiratory, cardiovascular and other physiological consequences of smoking cessation.
BACKGROUND: Smoking cessation is associated with substantial reductions in tobacco-related morbidity and mortality. Based on the current literature, the beneficial effects of quitting are particularly evident on pulmonary and cardiovascular function, but the negative physiological effects of cessation are less well documented. SCOPE: The objective of this article was to review systematically data on the physiological effects of smoking cessation. Articles based upon clinical trials, randomised controlled trials and meta-analyses were selected from titles and abstracts obtained via a MEDLINE search (May 2003-May 2008). Additional studies were identified from the bibliographies of reviewed literature.
FINDINGS: Smoking cessation is associated with improved lung function and a reduction in the presence and severity of respiratory symptoms. These changes, apparent within months of quitting, are sustained with long-term abstinence. The underlying pathophysiologies of smoking-induced airway inflammation and endothelial dysfunction are partially reversed following cessation in healthy ex-smokers, but not in those with chronic obstructive pulmonary disease. Smoking cessation is also associated with substantially improved cardiovascular function and reduced risk of primary and secondary cardiovascular morbidity and mortality. Although the overall long-term health benefits are unquestionable, smoking cessation is also associated with other possible undesirable short-term physiological effects such as weight gain, hypertension, constipation and mouth ulcers; and altered activity of the enzyme cytochrome P450 1A2 (CYP1A2), which metabolises many commonly used drugs.
CONCLUSION: The negative physiological effects of smoking cessation may adversely affect a smoker’s attempt to quit, and physicians should provide their smoking patients with motivation and regular encouragement and support when attempting to quit, whilst educating them on the health benefits of abstinence. Additionally, since cigarette smoke is a potent inducer of CYP1A2, patients attempting to quit smoking should have their dosages of drugs metabolised by this enzyme closely monitored.
Gratziou C. Curr Med Res Opin. 2009 Feb;25(2):535-45.
上一篇：
烟草相关疾病
下一篇：
环境烟草暴露与儿童行为的关系
