吸烟与非梗阻性无精子症发病风险的关联性研究  

Study on the relationship between smoking and the risk of nonobstructive azoospermia

作　　者：卢逸文 李梅 吴炜[1] LU Yi-wen;LI Mei;WU Wei(School of Public Health,Nanjing Medical University,Nanjing 211166,Jiangsu,China)

机构地区：[1]南京医科大学公共卫生学院,南京211166

出　　处：《医学研究生学报》2021年第12期1293-1297,共5页Journal of Medical Postgraduates

基　　金：江苏省高等学校自然科学研究重大项目(20KJA330001);江苏省卫生健康委医学科研项目(Z2019010)。

摘　　要：目的吸烟与多种疾病的发病风险升高相关。文中探讨不同吸烟行为特征和非梗阻性无精子症(NOA)发病风险的相关性。方法采用病例-对照研究方法选取2005年4月-2010年10月期间于南京医科大学第一附属医院、南京医科大学附属妇产医院和南京医科大学附属淮安第一医院就诊的患者作为研究对象。共纳入130例NOA患者作为病例组;同期选取577例正常生育的健康男性作为对照组。采用自行设计的调查问卷,通过调查员面访调查收集一般情况信息和吸烟行为特征等信息。在调整年龄、民族、BMI、受教育程度、咖啡饮用以及被动吸烟情况等混杂因素后,采用Logistic回归分析评估吸烟与N0A发病风险的关联。结果多因素Logistic回归分析结果显示,吸烟人群N0A发病风险为非吸烟人群的2.09倍(OR=2.09,95%CI:1.27~3.50,P=0.004)。亚组分析发现,与不吸烟者相比,开始吸烟年龄小于20岁和开始吸烟年龄在20~25岁的吸烟男性N0A发病风险均显著升高(小于20岁:OR=2.73,95%CI=1.36~5.66,P=0.006;20~25岁:OR=1.80,95%CI:1.02-3.24,P=0.046)。与不吸烟者相比,烟龄在5~10年之间和烟龄这10年的吸烟男性NOA发病风险显著升高(烟龄5~10年:OR=2.05,95% CI=1.11~3.88,P=0.024;烟龄3!10年:OR=2.49,95% CI=1.32~4.80,P=0.006)。年均吸烟量<5包和年均吸烟量>5包的吸烟男性N0A患病风险分别是不吸烟男性的1.93倍和2.37倍(年均吸烟量<5包:0R=1.93,95%CI=1.11~3.39,P=0.021;年均吸烟量彡5包:OR=2.37,95%CI=1.22〜4.68,P=0.012)。此外,每天吸烟支数<10和每天吸烟支数这10的男性NOA发病风险分别是非吸烟男性的2.48倍和1.82倍(每天吸烟支数<10:OR=2.48,95% CI=1.35~4.69,P=0.004;每天吸烟支数≥10:OR=1.82,95%CI=1.02〜3.29,P=0.044)。结论吸烟可显著增加NOA的发病风险。开始吸烟年龄较早、较长的烟龄、每天吸烟支数的增多和年均吸烟量的增多均可增加N0A发病风险。Objective Smoking is associated with an increased risk of a variety of diseases.The aim of the study is to explore the association between the risk of nonobstructive azoospermia(NOA)and different smoking behavior characteristics.Methods A total of 130 infertile men with NOA from the First Affiliated Hospital of Nanjing Medical University,the Obstetrics and Gynecology Hospital of Nanjing Medical University and the First Huaian Hospital Affiliated to Nanjing Medical University were included as the case group in this case-control study.During the same period,577 fertile men with normal reproductive capacity were selected as the control group.Self-designed questionnaires were used to collect general information and smoking behavior characteristics information through face-to-face interview with investigators.After adjusting for confounding factors including age,ethnicity,BMI,education level,coffee intake,and passive smoking status,logistic regression analysis was used to investigate the association between smoking and the risk of NOA.Results Multivariate logistic regression analysis showed that the risk of NOA in smokers was 2.09 times higher than that in nonsmokers(OR=2.09,95%CI=1.27-3.50,P=0.004).Compared with nonsmokers,smokers who started smoking younger than 20 years old and those who started smoking at the age of 20-25 had a significantly higher risk of NOA(for men of<20 years old:OR=2.73,95%CI=1.36-5.66,P=0.006;for men of 20-25 years old:OR=1.80,95%CI=1.02-3.24,P=0.046).Compared with nonsmokers,the risk of NOA was significantly increased in smoker who had smoked for 5-10 years and more than 10 years(for men who smoked for 5-10 years:OR=2.05,95%CI=1.11-3.880.024;for men who smoked for≥10 years:OR=2.49,95%Cl=1.32-4.80,0.006).The risk of NOA was 1.93 times and 2.37 times higher in men with smoking less than 5 pack-years and smoking more than 5 pack-years than nonsmokers(for smokers of less than 5 pack-years:OR=1.93,95%CI=1.11-3.39,P=0.021;for smokers of more than 5 pack-years:OR=2.37,95%CI=1.22-4.68,P=0.012).In

关 键 词：吸烟 非梗阻性无精子症 男性不育 精子生成障碍 

分 类 号：R394.1[医药卫生—医学遗传学]