吸烟与多发性硬化和视神经脊髓炎谱系疾病发病风险关联性研究  

Association of smoking with risk of multiple sclerosis and neuromyelitis optica spectrum disorders

作　　者：杨亭亭[1] 向雅娟 敖东慧 何洋[2] 王阳阳[2] 钟珊珊[2] 武剑[1] 刘广志[2] YANG Ting-ting XIANG Ya-juan AO Dong-hui HE Yang WANG Yang-yang ZHONG Shan-shan WU Jian LIU Guang-zhi(Department of Neurology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing 102218, China Department of Neurology, Peking University People＇s Hospital, Beijing 100044, China)

机构地区：[1]北京清华长庚医院神经内科清华大学医学中心,102218 [2]北京大学人民医院神经内科,100044

出　　处：《中国现代神经疾病杂志》2016年第9期598-602,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家自然科学基金资助项目(项目编号:81171123);北京市医院管理局"登峰"人才培养计划项目(项目编号:DFL20152201)~~

摘　　要：研究背景既往研究提示吸烟可以增加多发性硬化发病风险,但与视神经脊髓炎谱系疾病发病风险的关联性研究少见,本研究探讨吸烟与多发性硬化和视神经脊髓炎谱系疾病发病风险的关联性,以探讨吸烟是否增加上述两种疾病的发病风险。方法采用调查问卷和电话随访方式记录53例多发性硬化患者、62例视神经脊髓炎患者和85例正常对照者的吸烟暴露情况,包括开始吸烟年龄、吸烟持续时间、每日吸烟量和累积吸烟量,以及受试者配偶、父母是否吸烟,是否存在职业暴露。结果最终获得有效调查问卷和电话随访者156例（包括39例多发性硬化患者、43例视神经脊髓炎谱系疾病患者和74例正常对照者）,与不主动吸烟者（被动吸烟和不吸烟）相比,主动吸烟者发生多发性硬化（OR=10.800,95%CI：2.202～52.975;P=0.001）和视神经脊髓炎谱系疾病（OR=5.838,95%CI：1.123～30.357;P=0.050）的风险增加;与不吸烟者相比,吸烟者（主动吸烟和被动吸烟）发生多发性硬化（OR=3.444,95%CI：1.491～7.953;P=0.003）和视神经脊髓炎谱系疾病（OR=2.370,95%CI：1.039～5.407;P=0.038）的风险增加;与男性不吸烟者相比,男性吸烟者仅多发性硬化的发病风险增加（OR=15.000,95%CI：2.239～100.483;P=0.005）。结论吸烟可以增加多发性硬化的发病风险,但是否增加视神经脊髓炎谱系疾病的发病风险尚不明确。Background Previous studies showed that smoking is associated with increased multiple sclerosis（MS） susceptibility,while investigation of relation between smoking and risk of neuromyelitis optica spectrum disorders（NMOSDs） is rarely reported.Hence,this study aims to explore the association of smoking with MS and NMOSDs susceptibility and ascertain whether smoking can increase the risk of these two diseases.Methods Fifty- three MS patients,62 NMOSDs patients and 85 healthy individuals were enrolled in this study.Standardized questionnaire or follow- up by telephone call were adopted to collect information regarding whether patients,healthy controls and their relatives have smoking behavior,and to learn circumstances of active smoking and passive smoking in these subjects.Results There were 156 subjects who finished effective questionnaires and telephone follow-up,including 39 MS patients,43 NMOSDs patients and 74 controls.Compared with passive smoking and non-smoking subjects,the susceptibility of both MS（OR = 10.800,95%CI：2.202-52.975;P = 0.001） and NMOSDs（OR = 5.838,95%CI：1.123-30.357;P = 0.050） was significantly increased in active smoking subjects.Compared with non-smoking subjects,the susceptibility of both MS（OR = 3.444,95%CI：1.491-7.953;P = 0.003） and NMOSDs（OR = 2.370,95%CI：1.039-5.407;P = 0.038） was significantly increased in active and passive smoking subjects.In comparison with non-smoking males,smoking males were susceptible to MS（OR =15.000,95%CI：2.239-100.483;P = 0.005）.Conclusions Smoking is definitely the risk factor for MS,whereas it is not clear whether it is a risk factor for NMOSDs.

关 键 词：吸烟 多发性硬化 视神经脊髓炎 危险因素 

分 类 号：R744.5[医药卫生—神经病学与精神病学]