Division of Gastroenterology and Nutrition, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
Am J Gastroenterol. 2012 Sep;107(9):1399-406. doi: 10.1038/ajg.2012.196. Epub 2012 Jul 10.
Long-term data on the influence of cigarette smoking, especially cessation, on the risk of Crohn's disease (CD) and ulcerative colitis (UC) are limited.
We conducted a prospective study of 229,111 women in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHS II). Biennially, we collected updated data on cigarette smoking, other risk factors, and diagnoses of CD or UC confirmed by medical record review.
Over 32 years in NHS and 18 years in NHS II, we documented 336 incident cases of CD and 400 incident cases of UC. Compared with never smokers, the multivariate hazard ratio (HR) of CD was 1.90 (95% confidence interval (CI), 1.42-2.53) among current smokers and 1.35 (95% CI, 1.05-1.73) among former smokers. Increasing pack-years was associated with increasing risk of CD (Ptrend < 0.0001), whereas smoking cessation was associated with an attenuation of risk. By contrast, the multivariate HR of UC was 0.86 (95% CI, 0.61-1.20) among current smokers and 1.56 (95% CI, 1.26-1.93) among former smokers. The risk of UC was significantly increased within 2-5 years of smoking cessation (HR, 3.06; 95% CI, 2.00-4.67) and remained persistently elevated over 20 years.
Current smoking is associated with an increased risk of CD, but not UC. By contrast, former smoking is associated with an increased risk of UC, with risk persisting over two decades after cessation.
关于吸烟（尤其是戒烟）对克罗恩病（CD）和溃疡性结肠炎（UC）风险的长期影响的数据有限。
我们对护士健康研究（NHS）和护士健康研究 II（NHS II）中的 229111 名女性进行了前瞻性研究。每两年，我们通过病历审查收集关于吸烟、其他危险因素以及 CD 或 UC 确诊的更新数据。
在 NHS 中进行了 32 年，在 NHS II 中进行了 18 年，我们记录了 336 例 CD 新发病例和 400 例 UC 新发病例。与从不吸烟者相比，当前吸烟者的 CD 多变量风险比（HR）为 1.90（95%置信区间（CI），1.42-2.53），而前吸烟者为 1.35（95% CI，1.05-1.73）。吸烟包年数与 CD 风险增加相关（P<0.0001），而戒烟与风险降低相关。相比之下，当前吸烟者的 UC 多变量 HR 为 0.86（95% CI，0.61-1.20），而前吸烟者为 1.56（95% CI，1.26-1.93）。戒烟后 2-5 年内 UC 的风险显著增加（HR，3.06；95% CI，2.00-4.67），并且在 20 多年后仍持续升高。
当前吸烟与 CD 风险增加相关，但与 UC 无关。相反，以前吸烟与 UC 风险增加相关，且在戒烟后 20 多年仍持续存在。
