Feng Xin, Qian Zenghui, Zhang Baorui, Guo Erkang, Wang Luyao, Liu Peng, Wen Xiaolong, Xu Wenjuan, Jiang Chuhan, Li Youxiang, Wu Zhongxue, Liu Aihua
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2018 May 31;9:380. doi: 10.3389/fneur.2018.00380. eCollection 2018.
We aimed to investigate the effect of smoking on the risk of intracranial aneurysm (IA) rupture (IAR), specifically relationship between the number of cigarettes smoked per day (CPD) or smoking index and the risk of IAR.
We performed a single-center case-control study of consecutive patients evaluated or treated for IA at our institution from June 2015 to July 2016. Cases were patients with a ruptured IA. Two age- and sex-matched controls with an unruptured IA were included per case. Conditional logistic regression models were used to assess the relationship between both the CPD and smoking index (CPD × years of smoking) and IAR.
The study population included 127 cases of IAR and 254 controls. The higher IAR risk was associated with cigarette smoking (both current and former) (OR, 2.3; 95% CI, 1.1-4.8; = 0.029). Our subgroup analysis of smokers revealed a significant association between IAR risk and current smoking (OR, 2.8; 95% CI, 1.2-6.3; = 0.012), current heavy smoking (CPD ≥ 20) (OR, 3.9; 95% CI, 1.4-11.0; = 0.007), and a smoking index ≥800 (OR, 11.4; 95% CI, 2.3-24.5; = 0.003). Former smoking was not significantly associated with IAR (OR, 1.1; 95% CI, 0.3-4.0; = 0.929).
A dose-response relationship has been noted for intensity and duration of smoking consumption and increased risk of IAR. As smoking is modifiable, this finding is important to managing patients with IAs to quit or reduce smoking prior to life-threatening subarachnoid hemorrhage.
我们旨在研究吸烟对颅内动脉瘤（IA）破裂（IAR）风险的影响，特别是每日吸烟量（CPD）或吸烟指数与IAR风险之间的关系。
我们对2015年6月至2016年7月在我院接受IA评估或治疗的连续患者进行了单中心病例对照研究。病例为IA破裂患者。每例病例纳入两名年龄和性别匹配的未破裂IA对照。采用条件逻辑回归模型评估CPD和吸烟指数（CPD×吸烟年限）与IAR之间的关系。
研究人群包括127例IAR患者和254例对照。IAR风险较高与吸烟（包括当前吸烟和既往吸烟）相关（OR，2.3；95%CI，1.1 - 4.8；P = 0.029）。我们对吸烟者的亚组分析显示，IAR风险与当前吸烟（OR，2.8；95%CI，1.2 - 6.3；P = 0.012）、当前重度吸烟（CPD≥20）（OR，3.9；95%CI，1.4 - 11.0；P = 0.007）以及吸烟指数≥800（OR，11.4；95%CI，2.3 - 24.5；P = 0.003）之间存在显著关联。既往吸烟与IAR无显著关联（OR，1.1；95%CI，0.3 - 4.0；P = 0.929）。
已观察到吸烟量和吸烟持续时间与IAR风险增加之间存在剂量反应关系。由于吸烟是可改变的，这一发现对于管理IA患者在发生危及生命的蛛网膜下腔出血之前戒烟或减少吸烟具有重要意义。
