Matsumoto K, Akagi K, Abekura M, Ohkawa M, Tasaki O, Oshino S
Department of Neurosurgery, Hanwa Memorial Hospital, Osaka, Japan.
No Shinkei Geka. 1999 Sep;27(9):831-5.
Despite recent advances in diagnostic and therapeutic techniques, subarachnoid hemorrhage (SAH) is still a serious condition associated with high mortality and morbidity. There are no effective treatments other than surgical intervention. However, another option for decreasing the occurrence of SAH may be prevention of aneurysms formation and of their rupture by controlling risk factors. Cigarette smoking has been recently shown to be one of the major risk factors for SAH. We investigated whether cigarette smoking increased the risk of developing cerebral aneurysms and of SAH. Degree of smoking was investigated in 182 patients with SAH and in 123 patients with an unruptured cerebral aneurysm incidentally detected during investigation of other diseases. Sixty-nine patients with other diseases who were shown to be free of cerebral aneurysms through MR angiography served as controls. Smoking significantly increased the risk of both aneurysm formation and SAH; The odds ratio for SAH was 2.4, and for unruptured cerebral aneurysm 1.7. Smoking especially increased the occurrence of SAH in women and in youngsters. However, smoking did not influence the occurrence of cerebral vasospasm and multiplicity of aneurysms. These data suggest the importance of avoiding smoking to prevent the occurrence of cerebral aneurysms and of SAH.
尽管近年来诊断和治疗技术取得了进展,但蛛网膜下腔出血(SAH)仍然是一种严重的疾病,死亡率和发病率都很高。除了手术干预外,没有其他有效的治疗方法。然而,降低SAH发生率的另一种选择可能是通过控制危险因素来预防动脉瘤的形成及其破裂。最近的研究表明,吸烟是SAH的主要危险因素之一。我们调查了吸烟是否会增加患脑动脉瘤和SAH的风险。对182例SAH患者和123例在其他疾病检查中偶然发现的未破裂脑动脉瘤患者的吸烟程度进行了调查。69例通过磁共振血管造影显示无脑动脉瘤的其他疾病患者作为对照。吸烟显著增加了动脉瘤形成和SAH的风险;SAH的比值比为2.4,未破裂脑动脉瘤的比值比为1.7。吸烟尤其增加了女性和年轻人中SAH的发生率。然而,吸烟并不影响脑血管痉挛的发生和动脉瘤的多发性。这些数据表明避免吸烟对于预防脑动脉瘤和SAH发生的重要性。