Staffordshire Rheumatology Centre, University Hospital of North Staffordshire, the Institute of Science and Technology in Medicine, Keele University, Staffordshire, England.
J Rheumatol. 2011 Dec;38(12):2608-15. doi: 10.3899/jrheum.110641. Epub 2011 Oct 1.
To investigate the relationship between smoking and disease activity, pain, function, and quality of life in patients with ankylosing spondylitis (AS).
Patients with AS (n = 612) from areas across the United Kingdom took part in a cross-sectional postal survey. Patient-reported outcome measures including the Bath AS Disease Activity Index, the Bath AS Functional Index (BASFI), a numerical rating scale (NRS) of pain, the AS quality of life questionnaire (ASQoL), and the evaluation of AS quality of life measures (EASi-QoL) were analyzed in terms of smoking status and relationship with pack-year history. The influence of potential confounding factors [age, sex, disease duration, and social deprivation (Townsend Index)] were tested in multivariate logistic regression analyses.
Median scores of BASFI, pain NRS, ASQoL, and the 4 EASi-QoL domains were all higher in the group that had ever smoked compared to those who had never smoked (p < 0.0001, p = 0.04, p = 0.003, p < 0.02, respectively). In stepwise multivariate logistic regression analyses, high disease activity and more severe pain were associated primarily with current smoking, disease duration, and Townsend Index score, while decreased function and poor quality of life measures were associated more closely with increasing pack-year history, disease duration, and Townsend Index score. These associations were independent of age and sex.
Smoking has a dose-dependent relationship with measures of disease severity in AS. The association with increased disease activity, decreased function, and poor quality of life in smokers was independent of age, sex, deprivation level, and disease duration.
探讨吸烟与强直性脊柱炎（AS）患者的疾病活动度、疼痛、功能和生活质量之间的关系。
来自英国各地的 612 名 AS 患者参与了一项横断面邮寄调查。分析了患者报告的结局指标，包括 Bath AS 疾病活动指数（BASDAI）、Bath AS 功能指数（BASFI）、疼痛数字评分量表（NRS）、AS 生活质量问卷（ASQoL）和 AS 生活质量评估量表（EASi-QoL），并根据吸烟状况和与包年吸烟史的关系进行分析。在多变量逻辑回归分析中测试了潜在混杂因素（年龄、性别、疾病持续时间和社会剥夺程度（汤森德指数））的影响。
与从不吸烟者相比，曾吸烟者的 BASFI、疼痛 NRS、ASQoL 和 4 个 EASi-QoL 领域的中位数评分均较高（p < 0.0001，p = 0.04，p = 0.003，p < 0.02，分别）。在逐步多变量逻辑回归分析中，疾病活动度高和疼痛更严重主要与当前吸烟、疾病持续时间和汤森德指数评分相关，而功能下降和生活质量差则与包年吸烟史增加、疾病持续时间和汤森德指数评分更密切相关。这些关联独立于年龄和性别。
吸烟与 AS 的疾病严重程度呈剂量依赖性关系。吸烟与疾病活动度增加、功能下降和生活质量差之间的关联独立于年龄、性别、贫困程度和疾病持续时间。
