Adnot S
Service de physiologie, explorations fonctionnelles, hôpital Henri-Mondor, Créteil.
Arch Mal Coeur Vaiss. 1998 Oct;91 Spec No 5:53-8.
Smoking is one of the major causes of morbidity and mortality in the developed world. The main cause of death related to smoking is myocardial infarction. Smoking not only accelerates the process of atherosclerosis but also predisposes to acute complications, early in atheromatous disease, and which may be fatal. Complex effects implicated in cardiac complications include hypercoagulability, increased cardiac work, reduced oxygen transport and delivery, catecholamine liberation, and coronary vasoconstriction. These effects of tobacco which increase myocardial oxygen consumption whilst decreasing oxygen delivery, participate in precipitating acute cardiovascular complications. They are mainly related to the actions of nicotine and carbon monoxide. The atherogencity of smoking seems to be related to the many adverse effects on endothelial function, vascular tone, haemostasis, lipid profile and inflammatory cells. The action of oxidising and toxic glycation products, which are present in cigarette smoke and active on the vascular wall, are the principal mediators.
在发达国家，吸烟是发病和死亡的主要原因之一。与吸烟相关的主要死因是心肌梗死。吸烟不仅会加速动脉粥样硬化进程，还会使动脉粥样硬化疾病早期易于出现急性并发症，且这些并发症可能是致命的。与心脏并发症相关的复杂影响包括高凝状态、心脏工作负荷增加、氧运输和输送减少、儿茶酚胺释放以及冠状动脉血管收缩。烟草的这些作用增加了心肌耗氧量，同时减少了氧输送，参与引发急性心血管并发症。它们主要与尼古丁和一氧化碳的作用有关。吸烟的致动脉粥样硬化作用似乎与对内皮功能、血管张力、止血、血脂谱和炎症细胞的诸多不利影响有关。香烟烟雾中存在且作用于血管壁的氧化和毒性糖基化产物的作用是主要介导因素。
