德国研究人员首次比较了香烟,电子烟和水烟都会使动脉变硬


导言:吸烟是全球非传染性疾病的主要原因,也是心血管疾病(CVD)和肺部疾病的主要危险因素。近年来,电子烟作为一种新兴产品,尤其是在年轻一代中越来越受欢迎。然而与传统的香烟相比,电子烟对人体的危害存在相当大的争议。近日,德国的研究人员首次比较了香烟,电子烟和水烟对人体健康和心血管的危害。

目前,全世界前8位死因中,有6种与吸烟有关。烟草流行是对公众健康的最大威胁之一,是心血管疾病发病和死亡的主要原因。近日,德国的研究人员首次比较了香烟,电子烟和水烟对人体健康和心血管的危害,并发现香烟,电子烟和水烟都会使动脉变硬,引起炎症并破坏DNA,从而引起各种健康问题。

这项研究由德国美因茨大学医学中心心脏病学系的Thomas Münzel教授领导并于6月25日发表在《欧洲心脏杂志》上。题目为“Effects of tobacco cigarettes, e-cigarettes, and waterpipe smoking on endothelial function and clinical outcomes”
 

在这项研究中,科学家首次探究了香烟,电子烟和水烟对人体健康和血管内皮细胞功能的影响。综述了吸烟产生的有害化学物质的现有证据,以及吸烟影响身体的机制。研究人员还比较了三种烟对中风、心脏病和肺癌等疾病的影响。

先前已有研究表明,吸烟会导致内皮功能障碍和血管损伤。长期暴露在烟草烟雾中会损害乙酰胆碱依赖性血管舒张和冠状动脉血流,这与血浆胆固醇水平升高有关。研究小组发现,总体而言,香烟比电子烟的危害更大。然而,关于水烟和电子烟对内皮功能障碍的影响,数据不足。研究人员表示,水烟和电子烟的长期影响需要更深入的研究。同时,他们写道,“水烟的危害不亚于香烟,因此不能将水烟视为健康的替代品”。
 

三种烟对人体内皮功能的影响及抗氧化干预

三种烟对动物内皮功能的慢性和急性影响

研究人员回顾了一系列研究,这些研究分别为三种烟的危害性提供了证据。与不吸烟者相比,香烟使慢性阻塞性肺病(COPD)的风险增加704%,水烟增加218%,电子烟增加194%;香烟和水烟分别使肺癌的风险增加1210%和122%,有关电子烟的数据不充分,不足以得出可靠的结论。

他们还研究了三种烟对动脉硬化的影响,动脉硬化是心脏病和中风风险的重要预后指标。与不吸烟者相比,香烟使动脉硬化风险增加10%,水烟增加9%,电子烟增加7%。

这篇综述的第一作者,德国美因茨大学医学中心心脏病学系的Thomas Münzel教授说:“我们的综述主要集中在这三种烟对内皮功能障碍的不良影响以及与氧化应激的关系,并且与临床疾病有关。这三种烟都会导致血管组织中氧自由基(如超氧物)的增加。这会分解内皮细胞释放的一氧化氮,一氧化氮对帮助血管扩张、防止炎症和动脉阻塞非常重要。”
 

吸烟对内皮功能的影响机制

研究人员说,电子烟蒸气中的主要有毒化学物质包括甲醛和丙烯醛,以及痕量的过渡金属和挥发性有机化合物(VOCs),这些物质都会损伤细胞。相比之下,香烟和水烟含有更复杂的有害化学物质。水烟烟雾中含有固体颗粒物,主要来源于燃烧烟草的木炭;香烟烟雾中也存在浓度较低的固体颗粒物。三种烟都有尼古丁,具有成瘾性和有害的生物效应。
 

三种烟中的有毒化合物

Münzel教授说:“这些不同有毒化合物的重叠,可能是人们了解吸烟对健康的有害影响的关键,这需要今后的进一步研究。”

研究人员还观察了吸烟对COVID-19感染的影响。在文中,他们写道:“正如世界卫生组织所概述的那样,香烟和水烟可能会导致COVID-19的症状加重,其中包括接受重症监护、需要机械通气等更严重的后果。”

他们总结道:“毫无疑问,戒烟依然是预防吸烟引起的心血管和呼吸道疾病的最有效方法。鉴于COVID-19大流行,这一点可能更为重要,因为烟草制品的使用可能会增加吸烟者患COVID-19相关心血管和其他严重并发症的风险。”

Münzel教授说:“世卫组织警告,尽管电子烟似乎比香烟危害小,但越来越多的证据表明,电子烟也可能对肺、心脏和血管产生副作用,而且使用电子烟可能会增加COVID-19的感染风险。”

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