天津市2010-2014年急性冠心病发病者吸烟情况分析

目的 分析天津市急性冠心病事件患者中吸烟的流行特征及趋势分布。 方法 利用天津市主要慢性病发病登记监测系统中的吸烟信息,分析2010-2014年天津市急性冠心病事件的流行情况,并分析患者中吸烟与非吸烟的流行特征及趋势分布。 结果 2010-2014年间,天津市共报告居民急性冠心病事件38 805次,平均粗发病率为77.76/10万,男性(24 343人)多于女性(14 462人),且男性平均发病年龄小于女性,差异有统计学意义(t=54.31,P=0.00)。天津市急性冠心病事件的患者主要为急性心肌梗塞患者,占总发病人数的96.6%。不同性别急性心肌梗塞患者的吸烟率(男:55.0%;女:22.8%)高于冠心病猝死的患者(男:43.4%;女:12.3%),差异有统计学意义(男:χ²=48.96,P=0.00;女:χ²=52.43,P=0.00)。在冠心病猝死和急性心肌梗塞的患者中男性的吸烟率随年龄增加而呈现下降趋势,差异有统计学意义(χ²=46.56,P=0.00)。两种疾病的女性患者的吸烟率分别在>69~79和>59~69岁年龄组达到高峰,随后开始下降,仅在急性心肌梗塞患者中差异有统计学意义(χ²=112.76,P=0.00)。2010-2014年间,男性患者吸烟率整体呈现下降趋势,其中冠心病猝死患者的吸烟率下降的趋势有统计学意义(χ²=29.22,P=0.00),而女性患者吸烟率整体呈现上升趋势(χ²=10.73,P=0.00)。 结论 冠心病急性事件发病例数及发病率逐年增加,是严重危害居民健康的重要疾病。且冠心病急性事件患者的吸烟率较高,特别是60岁以下的人群,这是导致冠心病急性事件发病呈现年轻化的主要原因,因此应及时开展干预措施,降低吸烟率,提高戒烟率,应加大在女性中开展控烟宣传,以减少其吸烟相关疾病的发生。

Smoking status of patients with acute coronary heart disease in Tianjin, 2010-2014

Objective To analyze the epidemiological characteristics and tendency distribution of smoking in patients with acute coronary heart disease (ACHD) in Tianjin. Methods Utilizing the smoking information collected from the Incidence Surveillance System for Main Chronic Diseases in Tianjin, we investigated the prevalence of ACHD in Tianjin during 2010-2014, and then analyzed the epidemiological characteristics and tendency distribution of smoking and non-smoking among patients with ACHD. Results There were 38,805 ACHD events reported in Tianjin during 2010-2014, with the average crude incidence rate being 77.76/100,000. Male patients (n=24,343) were more than females ones (n=14,462); moreover, and the average age of disease onset was younger in males than in females, showing a statistically significant difference (t=54.31, P=0.00). Among the ACHD events occurred in Tianjin, patients with acute myocardial infarction accounted for 96.6% of the total cases. The prevalence rate of smoking was higher in patients with acute myocardial infarction (males: 55%, females: 22.8%) than in patients with sudden coronary death (males: 43.4%, females: 12.3%), with statistically significant differences (males: χ²=48.96,P=0.00; females: χ²=52.43,P=0.00). Among the male patients with sudden coronary death and male patients with acute myocardial infarction, the smoking rates showed a downward trend with the increase of age, and the difference was statistically significant (χ²=46.56, P=0.00). Among the female patients with the above-mentioned two diseases, the smoking rates reached the highest in the age groups of >69-79 and >59-69 years respectively, and then declined, only showing a statistically significant difference in patients with acute myocardial infarction (χ²=112.76, P=0.00). The smoking rate of male patients showed a general decreasing tendency during 2010-2014, only with a statistically significant difference in patients with sudden coronary death (χ²=29.22, P=0.00). But the smoking rate of female patients showed an overall upward trend (χ²=10.73, P=0.00). Conclusions The number of ACHD cases and its incidence rate increase year by year, and it is an important disease seriously endangering the health of residents. And the smoking rate of ACHD patients is high, especially the group aged < 60 years, which is the major cause for the younger tendency in morbidity age of ACHD patients. Therefore, it is necessary to timely conduct interventions so as to reduce the smoking rate and increase the rate of smoking cessation; meanwhile, propaganda about tobacco control should be further conducted among the females in order to decline the occurrence of smoking-related diseases.