Department of Nephrology, Lund University and Skåne University Hospital, Lund.
Scand J Rheumatol. 2011 Jan;40(1):51-6. doi: 10.3109/03009742.2010.487839. Epub 2010 Sep 21.
To study the association between late organ damage in patients with primary systemic vasculitis (PSV) and cigarette smoking. PSV included Wegener's granulomatosis (WG), microscopic polyangiitis (MPA), Churg-Strauss syndrome (CSS), and polyarteritis nodosa (PAN).
The pattern and extent of organ damage according to the Vasculitis Damage Index (VDI) were analysed for 86 prevalent cases with PSV retrieved from a geographically defined population in southern Sweden (46 WG, 27 MPA, four CSS, and nine PAN). Data on clinical findings, laboratory tests, and smoking habits were collected from case records from the time of diagnosis. The patients were stratified into two main groups according to their smoking habits: smokers (subdivided into active and ex-smokers) and non-smokers (patients who had never smoked).
Data on smoking habits were available for 77 patients (90%). Thirty-three (38%) patients were categorized as smokers and 44 (51%) were non-smokers. Smoking was more common in men (61.5% vs. 23.6% in women, p = 0.001). There were no differences in smoking habits between the main diagnostic groups (WG 40% smokers, MPA 45%). Ear, nose, and throat (ENT) damage was significantly more prevalent in non-smokers (p = 0.001). Myocardial infarction (MI) and end-stage renal disease (ESRD) were more common in the current smokers (p = 0.04) than in the non-smokers.
We found ENT damage to be significantly less prevalent in smokers. This is the first report of a possible modifying effect of cigarette smoking on the development of organ damage in PSV, but more studies are needed before any firm conclusions can be made.
研究原发性系统性血管炎（PSV）患者晚期器官损伤与吸烟之间的关系。PSV 包括韦格纳肉芽肿（WG）、显微镜下多血管炎（MPA）、Churg-Strauss 综合征（CSS）和多发性大动脉炎（PAN）。
从瑞典南部一个地理定义的人群中检索到的 86 例现患 PSV 病例（46 例 WG、27 例 MPA、4 例 CSS 和 9 例 PAN），根据血管炎损伤指数（VDI）分析器官损伤的类型和程度。从诊断时的病历中收集临床发现、实验室检查和吸烟习惯的数据。根据吸烟习惯将患者分为两组：吸烟者（分为活跃吸烟者和戒烟者）和非吸烟者（从未吸烟的患者）。
77 例患者（90%）有吸烟习惯数据。33 例（38%）患者被归类为吸烟者，44 例（51%）为非吸烟者。男性吸烟者更常见（61.5%比女性 23.6%，p = 0.001）。主要诊断组之间的吸烟习惯无差异（WG 吸烟者 40%，MPA 吸烟者 45%）。非吸烟者中耳部、鼻部和喉部（ENT）损伤更为常见（p = 0.001）。非吸烟者中心肌梗死（MI）和终末期肾病（ESRD）较常见（p = 0.04）。
我们发现吸烟者 ENT 损伤明显较少见。这是首次报道吸烟可能对 PSV 器官损伤的发生有修饰作用，但还需要更多的研究才能得出确切的结论。
