2020 年第 7 期 第 15 卷

吸烟对不同性别急性ST段抬高型心肌梗死患者住院死亡率的影响

Effect of smoking on the mortality rate of acute ST-segment elevation myocardial infarction patients with different genders

作者：杨丽霞周玉杰王志坚柴萌梁静张琳琳

英文作者：Yang Lixia Zhou Yujie Wang Zhijian Chai Meng Liang Jing Zhang Linlin

单位：首都医科大学附属北京安贞医院心内十二病房北京市心肺血管疾病研究所冠心病精准治疗北京市重点实验室首都医科大学冠心病临床诊疗与研究中心100029

英文单位：The 12th Ward Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Heart Disease Clinical Center for Coronary Heart Disease Capital Medical University Beijing 100029 China

关键词：急性心肌梗死；吸烟；性别

英文关键词：Acutemyocardialinfarction;Smoking;Sex

• 摘要：

• 目的探讨吸烟对不同性别急性ST段抬高型心肌梗死（STEMI）患者住院死亡率的影响。方法收集2013年1月1日至2016年12月31日就诊于首都医科大学附属北京安贞医院的3 907例STEMI患者的临床资料。所有患者根据性别和吸烟状态分为男性吸烟组（2 118例）、男性非吸烟组（1 270例）、女性吸烟组（81例）、女性非吸烟组（438例）。应用Logistic回归模型分析吸烟对急性STEMI患者住院死亡率的影响及性别间差异。结果男性患者吸烟比例明显高于女性［62.5%（2 118/3 388）比15.6%（81/519）］，差异有统计学意义（P<0.001)。女性患者年龄大于男性患者［（63±12）岁比（57±10）岁，P<0.001］。男性吸烟组患者的住院死亡率明显高于男性非吸烟组［4.5%（95/2 118）比 2.7%（34/1 270），P=0.008］。女性吸烟组患者的住院死亡率明显高于女性非吸烟组［6.2%（5/81）比 1.8%（8/438），P=0.021］。校正基线影响因素后，吸烟是急性STEMI患者住院死亡率的独立危险因素，对女性的影响较男性更大（女性：比值比=2.82，95%置信区间1.43～5.56，P=0.024；男性：比值比=1.62，95%置信区间1.03～2.54，P=0.011；交互作用P=0.045)。结论急性STEMI患者中女性吸烟比例明显低于男性，但女性吸烟患者住院死亡率更高。

• ObjectiveTo explore the effect of smoking on the mortality rate of acute ST-segment elevation myocardial infarction（STEMI） in patients with different gender. Methods A total of 3 907 patients with STEMI from January 1, 2013 and December 31, 2016 in Beijing Anzhen Hospital, Capital Medical University were selected. All patients were divided into male smoking group（2 118 cases）, male non-smoking group（1 270  cases）, female smoking group（81 cases） and female non-smoking group（438 cases）. The impact of cigarette smoking on in-hospital mortality and the interaction between the effect of smoking on death and sex were evaluated by Logistic regression model. Results  The smoking rate of male patients was significantly higher than that of female patients［62.5%（2 118/3 388） vs 15.6%（81/519）］; the difference was statistically significant（P<0.001). The age of female patients was higher than that of male patients［（63±12）years vs （57±10）years，P<0.001］. The in-hospital mortality of male smoking group was significantly higher than that of male non-smoking group ［4.5%（95/2 118） vs  2.7%（34/1 270），P=0.008］. The in-hospital mortality of female smoking group was significantly higher than that of female non-smoking group ［6.2%（5/81） vs  1.8%（8/438），P=0.021］. After adjusting for baseline characteristics, smoking was an independent predictor of in-hospital mortality in both male and female (for female, odds ratio=2.82, 95% confidence interval: 1.43-5.56, P=0.024; for male, odds ratio=1.62, 95% confidence interval: 1.03-2.54, P=0.011; interaction P=0.045). Conclusion Although the proportion of female with acute myocardial infarction is significantly lower than that of male, the mortality rate of female smokers is higher.