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目的调查中国冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)和缺血性脑卒中(ischemicstroke,IS)患者吸烟现状,分析影响其戒烟的因素。方法借助一项国际多中心大规模临床试验在中国实施之际,在14座城市的51家医院中对病史超过3个月的男性CHD或IS患者进行调查。利用电子问卷采集资料,进行统计描述和分析。结果于2007年6月至2009年10月期间,调查男性CHD或IS患者12 473例,调查对象年龄(63±8)岁,调查距发病的中位时间为18个月。吸烟率与目前吸烟率分别为72.7%和26.5%。接受冠状动脉血管重建术的患者戒烟率明显高于其他CHD或IS患者(OR=1.90,95%CI:1.71～2.11),合并糖尿病(OR=1.20,95%CI:1.10～1.32)或原发性高血压(OR=1.27,95%CI:1.17～1.39)的患者戒烟率高于其他CHD或IS患者。目前吸烟患者平均吸烟量为12支/d,平均吸烟量和重度吸烟者所占比例随年龄增加而下降(P<0.001)。结论对中国男性CHD或IS患者戒烟的干预措施仍然不足。对这些高危患者,尤其是中年患者加强控烟力度,将极大改善其预后。
Objective To investigate the smoking status of patients with coronary heart disease (CHD) and ischemic stroke (IS) in China and analyze the factors influencing smoking cessation. Methods With an international multicentre large-scale clinical trial in China, a survey of male CHD or IS patients with a history of over 3 months among 51 hospitals in 14 cities was conducted. Using electronic questionnaires to collect data, statistical description and analysis. Results From June 2007 to October 2009, 12 473 CHD or IS male subjects were surveyed, aged 63 ± 8 years. The median time to the survey was 18 months. Smoking rates and current smoking rates were 72.7% and 26.5% respectively. Patients who underwent coronary revascularization had significantly lower smoking cessation rates than those with other CHD or IS patients (OR = 1.90, 95% CI: 1.71-2.11), with diabetes mellitus (OR = 1.20, 95% CI: 1.10-1.32) Patients with Hypertension (OR = 1.27, 95% CI: 1.17 to 1.39) quit smoking more often than other CHD or IS patients. The current average number of smokers smoked was 12 cigarettes per day, with the average smoker and the proportion of heavy smokers declining with age (P <0.001). Conclusion Interventions for smoking cessation in Chinese male CHD or IS patients are still inadequate. To improve the control of these high-risk patients, especially middle-aged patients, will greatly improve their prognosis.