Sun Xiaobing, Huang Xiaoquan, Zhao Ruifeng, Chen Beibei, Xie Qin
Department of Internal Medicine, The Second People's Hospital of Nantong, Nantong, Jiangsu 226002, China.
Department of Internal Medicine, The Second People's Hospital of Nantong, Nantong, Jiangsu 226002, China.
Pancreatology. 2015 May-Jun;15(3):286-94. doi: 10.1016/j.pan.2015.03.001. Epub 2015 Mar 11.
Questions remain unclear about the association of smoking status and the development of acute pancreatitis (AP). We performed a meta-analysis of observational studies explore this association.
A computerized literature search was performed in MEDLINE and EMBASE through November 30, 2014. We also searched the reference lists of pertinent articles. We used a random-effects model to calculate the summary relative risks (SRRs) and their corresponding 95% confidence intervals (CIs).
A total of 3690 incident cases of AP included 12 observational studies (6 case-control and 6 prospective cohort/nested case-control studies) were identified. Compared with never smokers, the summary RR estimates were 1.54 (95% CI, 1.31-1.80) for ever smokers, 1.71 (95% CI, 1.37-2.14) for current smokers, and 1.21 (95% CI, 1.02-1.43) for former smokers. Smoking is found to be a potential risk factor for alcohol use, idiopathic factors and drugs related AP, but not for gallstone related AP, in the ever and current smokers. A dose-response effect of tobacco use on the risk was ascertained: current smokers had a 40% (95% CI, 30%-51%) increased risk of AP for every additional 10 cigarettes per day.
The present analysis suggests that smokers have an elevated risk of AP development. Further studies, however, are warranted before definitive conclusions can be drawn.
吸烟状态与急性胰腺炎（AP）发病之间的关联尚不清楚。我们进行了一项观察性研究的荟萃分析以探究这种关联。
截至2014年11月30日，在MEDLINE和EMBASE数据库中进行了计算机文献检索。我们还检索了相关文章的参考文献列表。我们使用随机效应模型计算汇总相对风险（SRR）及其相应的95%置信区间（CI）。
共纳入3690例AP发病病例，包括12项观察性研究（6项病例对照研究和6项前瞻性队列/巢式病例对照研究）。与从不吸烟者相比，既往吸烟者的汇总RR估计值为1.54（95%CI，1.31 - 1.80），当前吸烟者为1.71（95%CI，1.37 - 2.14），既往吸烟者为1.21（95%CI，1.02 - 1.43）。在既往吸烟者和当前吸烟者中，吸烟被发现是酒精使用、特发性因素及药物相关AP的潜在危险因素，但不是胆结石相关AP的危险因素。确定了烟草使用对风险的剂量反应效应：当前吸烟者每天每多吸10支烟，患AP的风险增加40%（95%CI，30% - 51%）。
目前的分析表明吸烟者患AP的风险升高。然而，在得出明确结论之前，还需要进一步研究。
