BRAIN and NERVE－神経研究の進歩63巻5号

2011年05月発行

総説

脳卒中と喫煙

著者： 橋本洋一郎¹

所属機関： ¹熊本市民病院神経内科

ページ範囲：P.483 - P.490

文献概要

はじめに

　喫煙は，悪性腫瘍，呼吸器疾患や循環器疾患の発症と関連することはよく知られている。一方，脳神経領域では，喫煙によってAlzheimer病やParkinson病の発症には抑制的に働くといわれていた。またわが国では欧米のように喫煙が脳卒中発症と関連するというデータがなかった。現在，喫煙はAlzheimer病の発症を促進し，またわが国でも脳卒中の発症に大きく関わっていることが示されている。

　喫煙は，(1)能動喫煙も受動喫煙も脳卒中の危険因子となり，用量に依存して増加する，(2)脳梗塞（約2倍）とくも膜下出血（約3倍）では明らかな危険因子となっているが，脳出血に関してはまだ危険因子としては確立されていない，(3)脳卒中に関して喫煙は中年層で最大の相対危険度を示し，高齢者では危険度は低下する，(4)女性喫煙者，特に経口避妊薬使用や前兆のある片頭痛などの危険因子を持つ場合はその毒性は高くなる^1）。本稿では喫煙と脳卒中の関連，さらに脳卒中患者の禁煙支援について述べる。

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