Meyers David G
Division of Cardiovascular Diseases and Department of Preventive Medicine, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160-7378, USA.
Curr Atheroscler Rep. 2003 Mar;5(2):146-9. doi: 10.1007/s11883-003-0087-x.
Acute myocardial infarction (AMI) and atherothrombotic stroke share a common pathogenesis involving disrupted atherosclerotic plaque and intravascular thrombosis. Both AMI and stroke have their peak incidence in winter months. Similarly, the incidence of upper respiratory infections (URIs), 38% of which are due to influenza, also peaks in winter (November and December). URIs result in many biochemical, cellular, and hemostatic changes that could predispose to plaque disruption and thrombosis. Infections, particularly URIs, frequently precede AMI and stroke. Up to 16% of persons older than 60 years of age experience a URI each year. Nineteen percent of those suffering an AMI recall a URI in the 2 weeks prior to their event. Three epidemiologic and one small clinical trial suggest that influenza vaccination is associated with a 50% reduction in incidence of sudden cardiac death, AMI, and ischemic stroke. Influenza vaccine is extremely safe and has a 50% efficacy. Theoretically, up to 104,500 AMIs and 192,000 nonembolic ischemic strokes could be prevented each year by influenza vaccination.
急性心肌梗死（AMI）和动脉粥样硬化血栓形成性卒中具有共同的发病机制，包括动脉粥样硬化斑块破裂和血管内血栓形成。AMI和卒中的发病率在冬季均达到峰值。同样，上呼吸道感染（URI）的发病率在冬季（11月和12月）也达到高峰，其中38%是由流感引起的。URI会导致许多生化、细胞和止血方面的变化，这些变化可能会引发斑块破裂和血栓形成。感染，尤其是URI，常常在AMI和卒中之前出现。每年60岁以上的人群中，高达16%的人会经历一次URI。19%的AMI患者回忆起在发病前2周内曾患过URI。三项流行病学研究和一项小型临床试验表明，接种流感疫苗可使心源性猝死、AMI和缺血性卒中的发病率降低50%。流感疫苗极其安全，有效率为50%。从理论上讲，每年通过接种流感疫苗可预防多达104,500例AMI和192,000例非栓塞性缺血性卒中。
