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与全国性吸烟立法禁令相关的心肌梗死发病率降低

Reduction incidence of myocardial infarction associated with a national legislative ban on smoking.

作者信息

Vasselli S, Papini P, Gaelone D, Spizzichino L, De Campora E, Gnavi R, Saitto C, Binkin N, Laurendi G

机构信息

Prevention Department, Italian Minister of Health, Rome, Italy.

出版信息

Minerva Cardioangiol. 2008 Apr;56(2):197-203.

Abstract

AIM

The aim of the present study was to assess change in admissions for acute myocardial infarction (AMI) in the period immediately subsequent to the coming into force of law no. 3/2003 ''Protection of the health of non-smokers''.

METHODS

Four Italian regions (Piedmont, Friuli Venezia Giulia, Lazio and Campania) took part in the study. Data regarding admissions for AMI were taken from the daily discharge papers of patients aged between 40 and 64 (cod. ICD9-CM 410.), in the period 10 January-10 March 2001-2005. Repeated admissions were excluded. Admission rates standardised by age and overall total, and specifically by region, age and gender were calculated. The hypothesis of a significant reduction between 2005 and 2004 was also checked.

RESULTS

The results showed a decrease in the number of cases and in the standardised rates between 2004 and 2005. The number of admissions estimated with a linear regression model for 2005 was significantly higher than that really observed (+13%). The decrease between the 2005 and 2004 rates was noteworthy for all four regions. Analysis by gender shows that the effect is observed only in male patients and in the age classes 45-49 and 50-54.

CONCLUSION

This study shows that there has been an appreciable reduction in the incidence of heart attacks in the period immediately subsequent to the coming into force of the non-smoking Law in the populations surveyed, and that this reduction mainly regards men of working age. The reduction reverses a trend that has been evident for a number of years, namely that of a decidedly upward trend in the number of admissions for AMI.

摘要

目的

本研究旨在评估第3/2003号法律“保护非吸烟者健康”生效后紧接着的时期内急性心肌梗死(AMI)入院人数的变化。

方法

四个意大利地区(皮埃蒙特、弗留利-威尼斯朱利亚、拉齐奥和坎帕尼亚)参与了该研究。关于AMI入院的数据取自2001 - 2005年1月10日至3月10日期间40至64岁患者(国际疾病分类第九版临床修订本编码410.)的每日出院记录。排除重复入院情况。计算了按年龄和总体标准化的入院率,以及按地区、年龄和性别具体标准化的入院率。还检验了2005年与2004年之间显著降低的假设。

结果

结果显示2004年至2005年病例数和标准化率有所下降。用线性回归模型估计的2005年入院人数显著高于实际观察到的人数(+13%)。所有四个地区2005年与2004年的发病率下降都值得注意。按性别分析表明,这种影响仅在男性患者以及45 - 49岁和50 - 54岁年龄组中观察到。

结论

本研究表明,在所调查人群中,禁烟法生效后紧接着的时期内心脏病发作发病率有明显降低,且这种降低主要涉及工作年龄的男性。这种降低扭转了多年来明显的趋势,即AMI入院人数呈明显上升趋势。

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