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患有多发性硬化症的吸烟者的生活质量和残疾程度下降幅度大于不吸烟者。

Smokers with MS have greater decrements in quality of life and disability than non-smokers.

机构信息

Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.

Center for Health Care Research and Policy, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Mult Scler. 2017 Nov;23(13):1772-1781. doi: 10.1177/1352458516685169. Epub 2017 Jan 6.

Abstract

BACKGROUND

Tobacco smoke plays a pathogenic role in multiple sclerosis (MS) and may accelerate disease progression, yet, some people with MS continue to smoke after disease onset. The average smoker reports diminished health-related quality of life (HRQOL) across many populations.

OBJECTIVES

To describe the relationships between smoking status and HRQOL, disease activity, and global disability in a US population with MS.

METHODS

We compared smokers to non-smokers in 950 responders to the Spring 2014 update survey completed by North American Research Committee on Multiple Sclerosis (NARCOMS) registry participants. HRQOL was assessed using Short Form-12 version 2 (SF-12v2), disease activity was investigated using eight Performance Scales (PS) and three Functionality Scales (FS). Global disability was evaluated using Patient Determined Disease Steps (PDDS) and an item response theory (IRT) summed score based on the PS and FS.

RESULTS

Smokers had lower HRQOL ( p < 0.0001), reported more disease activity ( p < 0.05) and greater deficits in all PS and FS ( p = 6 × 10 to 0.05), except mobility. Smokers and non-smokers did not differ by PDDS but had substantially greater IRT global disability ( p = 2 × 10).

CONCLUSION

Active smoking is meaningfully associated with deficits across multiple domains in people with MS and adds to the growing literature of the need for MS-tailored smoking cessation programs.

摘要

背景

烟草烟雾在多发性硬化症(MS)中起着致病作用,并可能加速疾病进展,但仍有一些 MS 患者在发病后继续吸烟。一般吸烟者报告称,他们在许多人群中的健康相关生活质量(HRQOL)都会下降。

目的

描述美国多发性硬化症患者中吸烟状况与 HRQOL、疾病活动度和全球残疾之间的关系。

方法

我们比较了北美多发性硬化症研究委员会(NARCOMS)登记参与者在 2014 年春季更新调查中完成的 950 名应答者中的吸烟者和不吸烟者。使用健康调查简表 12 项版本 2(SF-12v2)评估 HRQOL,使用八项表现量表(PS)和三项功能量表(FS)调查疾病活动度。使用患者确定疾病阶段(PDDS)和基于 PS 和 FS 的项目反应理论(IRT)总和评分评估全球残疾。

结果

吸烟者的 HRQOL 较低(p<0.0001),报告的疾病活动度较高(p<0.05),并且在所有 PS 和 FS 中表现出较大的缺陷(p=6×10 至 0.05),除了移动性。吸烟者和不吸烟者在 PDDS 上没有差异,但在 IRT 全球残疾方面有明显差异(p=2×10)。

结论

在多发性硬化症患者中,主动吸烟与多个领域的缺陷明显相关,并增加了多发性硬化症个体化戒烟计划必要性的不断增加的文献。

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