Circulation：吸烟增静脉血栓栓塞风险

　　英国学者的一项研究表明，在通常情况及术后，现时吸烟者的静脉血栓栓塞发病率均较高；吸烟为评估手术患者静脉血栓栓塞的另一危险因素。论文于2013年3月12日在线发表于《循环》（Circulation）。

　　此项大型前瞻性研究共纳入1162718例平均年龄为56岁的女性受试者，并进行了为期6年的随访。在未行手术以及术后12周情况下，评估与吸烟习惯相关的静脉血栓栓塞发病率。

　　结果显示，随访期间共有4630例受试者因静脉血栓栓塞而住院或死亡。在未行手术情况下，现时吸烟者的静脉血栓栓塞发病率显著高于从未吸烟者（校正相对危险度[RR] 1.38），并且重度吸烟者（≥15支/天）的相应风险显著高于轻度吸烟者（＜15支/天）。现时吸烟者接受手术治疗的可能性亦高于从未吸烟者（RR 1.12）。在行手术治疗的女性中，现时吸烟者术后12周的静脉血栓栓塞发病率显著高于从未吸烟者（RR 1.16）。

与血栓相关的拓展阅读：

• JACC:左心耳胸腔镜切除有效预防血栓栓塞复发
• CA-CANCER J CLIN ：血栓栓塞预示胰腺癌不良预后
• 利伐沙班可作为静脉血栓栓塞的标准抗凝疗法
• JAMA：减少动脉粥样硬化性血栓形成实现持续健康
• Am Heart J：EPICOR研究有望明确ACS患者的抗血栓药物应用模式
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Smoking, Surgery, and Venous Thromboembolism Risk in Women: UK Cohort Study

Background—Evidence about the effect of smoking on venous thromboembolism risk, generally and in the post-operative period, is limited and inconsistent. We examined the incidence of venous thromboembolism in relation to smoking habits, both in the absence of surgery and in the first 12 post-operative weeks in a large prospective study of UK women.

Methods and Results—During 6 years' follow-up of 1,162,718 women, mean age 56 years, 4630 were admitted to hospital for or died from venous thromboembolism. In the absence of surgery, current smokers had a significantly increased incidence of venous thromboembolism compared to never smokers (adjusted relative risk [RR]=1.38 [95% confidence interval 1.28-1.48]), with significantly greater risks in heavier than lighter smokers (RRs 1.47 [1.34-1.62] and 1.29 [1.17-1.42] for 15+ versus <15 cigarettes/day). Current smokers were also more likely to have surgery than never smokers (1.12 [1.12-1.13]). Among women who had surgery, the incidence of venous thromboembolism in the first 12 post-operative weeks was significantly greater in current than never smokers (1.16 [1.02-1.30]).

Conclusions—Venous thromboembolism incidence was increased in current smokers, both in the absence of surgery and in the 12 weeks following surgery. Smoking is another factor to consider when assessing venous thromboembolism risk in patients undergoing surgery.