吸烟和饮酒对成年人过敏性鼻炎和非过敏性鼻炎发病的影响:一项病例对照研究  

The influence of smoking and drinking on adult allergic rhinitis and non-allergic rhinitis:a case-control study

作　　者：杨晓喆 赵金铭 司马宇彤 赵妍 王向东 张罗[1,2,3] YANG Xiaozhe;ZHAO Jinming;SIMA Yutong;ZHAO Yan;WANG Xiangdong;ZHANG Luo(Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Otolaryngology,Beijing Laboratory of Allergic Diseases,Beijing Municipal Education Commission,Beijing Key Laboratory of Nasal diseases,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100005,China;Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Department of Allergy,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京市耳鼻咽喉科研究所,过敏性疾病北京实验室,鼻病研究北京市重点实验室,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100005 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [3]首都医科大学附属北京同仁医院变态反应科,北京100730

出　　处：《中国耳鼻咽喉头颈外科》2023年第7期438-442,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家重点研发计划(2022YFC2504100);教育部长江学者创新团队(IRT13082);中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-022);首都临床特色诊疗技术研究及转化应用重点项目(Z211100002921057);国家自然科学基金(82101190、82171110、82000962、81970852);北京市自然科学基金(7222024);北京市卫生系统高层次公共卫生技术人才建设专项经费(领军人才-01-08、领军人才-02-09)。

摘　　要：目的 研究吸烟和饮酒等因素对过敏性鼻炎(AR)和非过敏性鼻炎(non allergic rhinitis,NAR)发病的影响。方法我们开展一项全国范围的问卷调查,共获得1 964份有效问卷。统计志愿者(包括796名AR,542名NAR和626名对照)的年龄、性别、身高、体重、职业、居住地和文化程度等人口统计学及基线资料,另外收集吸烟、饮酒、合并症等信息。按年龄、性别进行配对获得两项1∶1病例对照研究(579对AR vs.对照,506对NAR vs.对照)。利用多因素条件Logistic回归分析,计算吸烟饮酒等影响因素的比值比(odds ratio,OR)和95%置信区间(CI)。结果 多因素回归分析发现,饮酒[OR=1.42(95%CI:1.057-1.908),P=0.0199]和吸烟[OR=1.496(95%CI:1.046-2.14),P=0.0272]是AR发病的危险因素,乡镇居住为保护因素[OR=0.665(95%CI:0.444-0.996),P=0.0476],职业分类与AR发病无显著关联。男性患AR风险高于女性[OR=1.485(95%CI:1.104-1.997),P=0.0089]。分层分析后发现偶尔饮酒、吸烟史5~10年、饮酒史5~10年是AR发病的确证危险因素。但是否饮酒和吸烟均不构成NAR发病的显著的危险因素(P=0.1404和0.9751),分层分析后,也无其他确证危险和保护因素的发现。结论 本研究发现饮酒和吸烟是AR发病的确证危险因素,且此危险因素对AR发病的影响大于NAR,限制饮酒和吸烟作为预防AR发病的手段具有流行病学意义。OBJECTIVE To explore the influence of smoking and drinking on the incidence of allergic rhinitis(AR) and non-allergic rhinitis(NAR).METHODS We conducted a nationwide survey and obtained a total of 1964 valid questionnaires.The demographics and baseline data of volunteers(including 796 AR,542 NAR and 626 control),including age,gender,height,weight,occupation,residence,education level etc.were collected.In addition,smoking,drinking,complications and other information were collected.Two 1:1 case-control studies(579 AR vs.control and 506 NAR vs.control) were matched according to age and sex.The conditional logistic regression was used to calculate the odds ratio(Odds ratio,OR) and 95% confidence interval(CI) of smoking,drinking and other influencing factors.RESULTS Result showed that drinking[OR=1.42(95%CI:1.057-1.908),P=0.0199] and smoking[OR=1.496(95%CI:1.046-2.14),P=0.0272] were risk factors for AR,while town residence was a protective factor[OR=0.665(95%CI:0.444-0.996),P=0.0476].There was no significant association between occupation and AR.The risk of AR in males is higher than that in females[OR=1.485(95%CI:1.104-1.997),P=0.0089].After stratified analysis,occasional drinking,a smoking history of 5-10 years and a drinking history of 5-10 years are confirmed risk factors for AR.However,in NAR,drinking and smoking were not significant risk factors(P=0.1404 and 0.9751,respectively).After stratified analysis,no other risk and protective factors were confirmed.CONCLUSION This study found that drinking and smoking are confirmed risk factors for AR,and their impact on AR is greater than that of NAR.Limiting drinking and smoking as prevention for AR has epidemiological significance.

关 键 词：鼻炎 过敏 鼻炎 变应性 常年性 吸烟 饮酒 危险因素 病例对照研究 非过敏性鼻炎 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]