肺心病标化截缩死亡率与吸烟关系的队列研究

作者采用队列研究方法对农民肺心病标化截缩死亡率与吸烟的关系进行了研究。对３５岁以上的农民２９４９８人５年随访的结果显示：肺心病死亡在全死因中的构成比为３０．３５％，居首位；男女性吸烟率分别为８６．４８％和３８．９６％；男女吸烟者肺心病标化死亡率与不吸烟者差异无显著性，相对危险度（ＲＲ）为１左右（Ｐ＞０．０５）；按性别和年龄分层分析表明各年龄组肺心病标化死亡率随年龄增大而增高，其间无显著性差异（Ｐ＞０．０５）；肺心病标化截缩死亡率随累计吸烟量增加而升高，虽然小剂量短时期吸烟与肺心病标化截缩死亡率间的关系不明显，ＲＲ也为１左右（Ｐ＞０．０５），但是，当累计吸烟总量达一定阈值时，（吸晒烟量达２７０ｋｇ以上，吸香烟量达２００００包以上），其ＲＲ为１．４０～３．９４；归因危险度为１７１～１６１０／１０万人年（Ｐ＜０．０５～０．０１）。

A Cohort Study on the Relationship Between Standardized Mortality of Pulmonary Heart Disease and Smoking

We explored the relationship between the standardized mortality of pulmonary heart disease (PHD) and smoking at Shifang county through a five year follow up study of 29 498 farmers over 35 years old. The death ratio of PHD was 30.35%, which stood first in all causes of death. The mortality of PHD for cigar/cigarette smokers regardless of sex was not significantly different from that for nonsmokers ( P >0.05). The RR was 1 or so. The analysis of data stratified by age showed that the specific mortality increased with age in spite of some inequalities in smoking; the RR of PHD for cigar/cigarette smokers in all age groups were 1 or so revealing no significant differences ( P >0.05). However, the standardized mortality of PHD increased with the accumulated amount of smoking. The relationship between the mortality of PHD and short term smoking with small dose was not significant ( P >0.05), but when the accumulated amount reached certain level, i.e. the smoker consumed cigar more than 270kg or consumed cigarette more than 20 000 packs, the relationship between the behavior of cigar/cigarette smoking and the mortality of PHD became apparent. The RRs were 1.40 3.94 and the ARs 171 1610 per 100 000 personyears (P < 0.05 0.01).