戒烟6个月后的主动脉反射波反应改善：一个前瞻性研究
2009/07/30
背景：吸烟是心血管疾病一个可预防的重要的的病因，吸烟与大动脉的僵硬度增加相关，而大动脉的将硬度是心血管疾病的独立预测因子。
方法：研究慢性重度吸烟的患者6个月戒烟后对主动脉僵硬度、中心压和波反射的效果。71名长期重度吸烟者（>20 支/天，呼气羧基血红蛋白 (COHb) >=4% ，CO ppm >=21）参与了6个月的基于心理学指导的戒烟项目，其中的83%为血压正常者）。受试者分为两组：第1组有31名患者，年龄 45+/-2岁,71% 为男性,完全戒烟6个月(在1,3,6个月测COHb <2%，CO ppm <10 ) ，第2组有40名患者，年龄45+/-1岁,73%为男性, 不改变吸烟习惯。测定主动脉僵硬度的基线值和6个月后的改变，评价的内容包括：脉搏波速率，中心-外周脉搏压放大率(PPAr), 波反射（增强指数以心率校正），增强压和循环时间。在基线和6个月时采集36 个患者 (组1 n = 19，组2 n =17 )的动态24h血压数据。
结论：6个月的戒烟与发射波、中心压和主动脉僵硬度的明显改善，以及日间血压的降低是相关联的。这可能是戒烟能够改善心血管预后的原因。
方法：研究慢性重度吸烟的患者6个月戒烟后对主动脉僵硬度、中心压和波反射的效果。71名长期重度吸烟者（>20 支/天，呼气羧基血红蛋白 (COHb) >=4% ，CO ppm >=21）参与了6个月的基于心理学指导的戒烟项目，其中的83%为血压正常者）。受试者分为两组：第1组有31名患者，年龄 45+/-2岁,71% 为男性,完全戒烟6个月(在1,3,6个月测COHb <2%，CO ppm <10 ) ，第2组有40名患者，年龄45+/-1岁,73%为男性, 不改变吸烟习惯。测定主动脉僵硬度的基线值和6个月后的改变，评价的内容包括：脉搏波速率，中心-外周脉搏压放大率(PPAr), 波反射（增强指数以心率校正），增强压和循环时间。在基线和6个月时采集36 个患者 (组1 n = 19，组2 n =17 )的动态24h血压数据。
结论：6个月的戒烟与发射波、中心压和主动脉僵硬度的明显改善，以及日间血压的降低是相关联的。这可能是戒烟能够改善心血管预后的原因。
（张永明编译 刘国梁审校）
Blood Pressure Monitoring. 14(2):69-75, April 2009
Improvement of aortic reflection wave responses 6 months after stopping smoking: a prospective study.
Polonia, Jorge; Barbosa, Loide; Silva, Jose Alberto; Rosas, Manuel
Unidade Hipertensao e Risco Cardiovascular, Hospital Pedro Hispano, Matosinhos, Faculdade de Medicina do Porto, Faculdade Ciencias da Saude, Universidade Fernando Pessoa, Porto, Portugal
Polonia, Jorge; Barbosa, Loide; Silva, Jose Alberto; Rosas, Manuel
Unidade Hipertensao e Risco Cardiovascular, Hospital Pedro Hispano, Matosinhos, Faculdade de Medicina do Porto, Faculdade Ciencias da Saude, Universidade Fernando Pessoa, Porto, Portugal
Background: Cigarette smoking is one important preventable cause of cardiovascular illness that has been associated with increased stiffness of large arteries and wave reflection, which are independent predictors of cardiovascular disease.
Methods: We investigated the effect of a 6-month quitting smoking programme on aortic stiffness, central pressure and wave reflections in chronic heavy smokers. Seventy-one (83% normotensives) long-term heavy smokers [>20 cigarettes/day and exhaled carboxy haemoglobin (COHb) (>=4% and CO ppm >=21)] completed a 6-month psychological-based stop-smoking program. Patients were divided into two groups. Thirty-one patients aged 45+/-2 years, 71% male, fully quit smoking for 6 months (COHb <2% and CO ppm <10 at 1, 3 and 6 months) - group I, whereas 40 patients aged 45+/-1 years, 73% male, did not change their smoking habits - group II. We measured between baseline and changes after 6 months in aortic stiffness assessed as pulse wave velocity (Complior), central-peripheral pulse pressure (PP) amplification ratio (PPAr), wave reflection (augmentation index corrected for heart rate), augmentation pressure and transit time (Sphygmocor). Ambulatory 24 h blood pressure (ABP) data were obtained at baseline and after 6 months in 36 patients (n = 19) of group I and 17 of group II.
Results: In group I, but not in group II, there were significant reductions of peripheral systolic BP (baseline: 131+/-4 to after 6 months: 127+/-4 mmHg, P<0.04) and of systolic BP (baseline: 121+/-4 to after 6 months: 114+/-4 mmHg, P<0.03). In group I from baseline to after 6 months, PPAr increased by 13.1+/-4.1% and transit time (ms) by 8.7+/-2.9%; augmentation index was reduced by 9.2+/-1.6%, augmentation pressure by 5.7+/-1.9 mmHg (all P<0.03 vs. baseline and vs. group II); and pulse wave velocity by 2.3+/-2.8% (P = 0.062). In group I, only daytime ABP was reduced from baseline to after 6 months (129/82+/-2/2 to 123/78+/-2/2 mmHg, P<0.03), whereas no change in 24h-ABP was found in group II.
Conclusion: Six months of smoking cessation is associated with clear improvement of reflected waves, central pressure and aortic stiffness, and with a reduction of daytime BP. This may contribute to the improvement of cardiovascular prognosis attributed to smoking cessation.
Accession Number 00126097-200904000-00003.
DOI Number 10.1097/MBP.0b013e32832941ea
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母亲怀孕期吸烟与儿童18个月时的表面化行为问题：一个基于人群的前瞻性研究的结果
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吸烟在膀胱癌的发病和进展中的病因作用，以及泌尿科医生在戒烟中的责任
