Qureshi A I, Suri M F, Yahia A M, Suarez J I, Guterman L R, Hopkins L N, Tamargo R J
Department of Neurosurgery, State University of New York, Buffalo, USA.
Neurosurgery. 2001 Sep;49(3):607-12; discussion 612-3. doi: 10.1097/00006123-200109000-00014.
Cigarette smoking has been demonstrated to increase the risk of subarachnoid hemorrhage (SAH). Whether cessation of smoking decreases this risk remains unclear. We performed a case-control study to examine the effect of smoking and other known risk factors for cerebrovascular disease on the risk of SAH.
We reviewed the medical records of all patients with a diagnosis of SAH (n = 323) admitted to Johns Hopkins Hospital between January 1990 and June 1997. Controls matched for age, sex, and ethnicity (n = 969) were selected from a nationally representative sample of the Third National Health and Nutrition Examination Survey. We determined the independent association between smoking (current and previous) and various cerebrovascular risk factors and SAH by use of multivariate logistic regression analysis. A separate analysis was performed to determine associated risk factors for aneurysmal SAH.
Of 323 patients admitted with SAH (mean age, 52.7+/-14 yr; 93 were men), 173 (54%) were hypertensive, 149 (46%) were currently smoking, and 125 (39%) were previous smokers. In the multivariate analysis, both previous smoking (odds ratio [OR], 4.5; 95% confidence interval [CI], 3.1-6.5) and current smoking (OR, 5.2; 95% CI, 3.6-7.5) were significantly associated with SAH. Hypertension was also significantly associated with SAH (OR, 2.4; 95% CI, 1.8-3.1). The risk factors for 290 patients with aneurysmal SAH were similar and included hypertension (OR, 2.4; 95% CI, 1.8-3.2), previous smoking (OR, 4.1; 95% CI, 2.7-6.0), and current smoking (OR, 5.4; 95% CI, 3.7-7.8).
Hypertension and cigarette smoking increase the risk for development of SAH, as found in previous studies. However, the increased risk persists even after cessation of cigarette smoking, which suggests the importance of early abstinence from smoking.
吸烟已被证明会增加蛛网膜下腔出血（SAH）的风险。戒烟是否能降低这种风险仍不清楚。我们进行了一项病例对照研究，以探讨吸烟及其他已知的脑血管疾病风险因素对SAH风险的影响。
我们回顾了1990年1月至1997年6月期间入住约翰霍普金斯医院的所有诊断为SAH的患者（n = 323）的病历。从第三次全国健康与营养检查调查的全国代表性样本中选取年龄、性别和种族相匹配的对照（n = 969）。我们通过多因素逻辑回归分析确定吸烟（当前吸烟和既往吸烟）与各种脑血管风险因素和SAH之间的独立关联。进行了一项单独分析以确定动脉瘤性SAH的相关风险因素。
在323例因SAH入院的患者中（平均年龄52.7±14岁；93例为男性），173例（54%）患有高血压，149例（46%）当前吸烟，125例（39%）既往吸烟。在多因素分析中，既往吸烟（比值比[OR]，4.5；95%置信区间[CI]，3.1 - 6.5）和当前吸烟（OR，5.2；95% CI，3.6 - 7.5）均与SAH显著相关。高血压也与SAH显著相关（OR，2.4；95% CI，1.8 - 3.1）。290例动脉瘤性SAH患者的风险因素相似，包括高血压（OR，2.4；95% CI，1.8 - 3.2）既往吸烟（OR，4.1；95% CI，2.7 - 6.0）和当前吸烟（OR，5.4；95% CI，3.7 - 7.8）。
如先前研究所示，高血压和吸烟会增加SAH发生的风险。然而，即使戒烟后风险仍会增加，这表明早期戒烟的重要性。
