空气污染和心肌梗塞-新吸烟者的悖论?
Friederike von Lewinski1, Franz Quehenberger2, Michael Sacherer3
1Division of Endocrinology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
在低污染地区,环境空气污染对心肌梗塞 (MI) 的短期风险很小. 然而,活跃吸烟者对空气污染物的反应发生了变化,这种现象可能与"吸烟者"有关.
科学领域:
- 环境健康 环境健康
- 心血管流行病学心血管流行病学
- 公共卫生 公共卫生
背景情况:
- 环境空气污染是一个公认的公共卫生问题,影响心血管健康.
- 现有的研究表明,空气污染物带来的风险很大,但影响往往很小,在高度污染的地区进行研究.
研究的目的:
- 研究特定空气污染物对心肌梗塞 (MI) 发病率的短期影响.
- 分析这些影响在具有常见并发性疾病的子组和活跃吸烟者中.
主要方法:
- 在奥地利斯泰里亚州,有12581例心肌梗塞病例 (2007-2015) 的前性注册表数据.
- 使用通用线性模型分析颗粒物 (PM2.5,PM10) 和气态污染物 (NO2,CO,SO2,O3,NOx).
- 对糖尿病患者,高血压患者,心力衰竭患者,COPD患者和目前吸烟者的分层分析.
主要成果:
- 在一般队列或子组 (DM,HTN,HFrEF,COPD) 中,污染物和MI发病率之间没有显著的关联.
- 活跃吸烟者在高NO2,CO,SO2和NOx时表现出心脏病风险降低,但在臭氧时风险增加.
- 吸烟者的这些发现可能与"吸烟者的悖论"有关.
结论:
- 在低污染地区,空气污染物对心肌梗塞的短期风险很小或微不足道.
- 活跃吸烟者对环境空气污染暴露的生理反应有明显的变化.
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