Wang Hanbin, Wang Luxuan, Wang Jiyue, Zhang Lijian, Li Chunhui
School of Clinical Medicine, Affiliated Hospital of Hebei University, Hebei University, Baoding, China.
Department of Neurology, Affiliated Hospital of Hebei University, Hebei University, Baoding, China.
Front Neurol. 2022 Jul 12;13:862916. doi: 10.3389/fneur.2022.862916. eCollection 2022.
Aneurysms of the cerebral vasculature are relatively common, which grow unpredictably, and even small aneurysms carry a risk of rupture. Rupture of intracranial aneurysms (IA) is a catastrophic event with a high mortality rate. Pieces of evidence have demonstrated that smoking is closely related to the formation and rupture of IA. However, the biological effect of smoking cigarettes on the formation and rupture of IA is still underrepresented.
The study protocol was prospectively registered in PROSPERO, registration number CRD42020203634. We performed a systematic search in PubMed and CNKI for studies exploring the biological effects of smoking on intracranial aneurysms published up to December 2021, and all studies were included in the analysis. The RevMan software was used for data analysis.
A total of 6,196 patients were included in 14 original articles in this meta-analysis. The risk of ruptured IA in the current smoking group was significantly higher than that in the non-smoking group, with statistical significance (RR = 1.23, 95% : 1.11-1.37). After heterogeneity among cohorts was removed by the sensitivity analysis, there was still a statistically significant difference in the risk of ruptured IA between the smoking and non-smoking groups (RR total = 1.26, 95% : 1.18-1.34). There was no statistically significant difference in the risk of ruptured IA between the former smoking (smoking cessation) group and the non-smoking group (RR = 1.09, 95% : 0.50-2.38). After heterogeneity among cohorts was removed by sensitivity analysis, there was still no statistically significant difference in the risk of ruptured IA between the former smoking (smoking cessation) group and the non-smoking group (RRtotal = 0.75, 95% : 0.47-1.19). The risk of the ruptured IA in the current smoking group was significantly higher than that in the former smoking (smoking cessation) group, with a statistically significant difference (RR=1.42, 95%: 1.27-1.59).
Although the biological effects of smoking on the formation and rupture of IA are unknown, this study suggests that current smoking is a risk factor for ruptured IA. Quitting smoking is very important for patients with IA.
脑血管动脉瘤相对常见，其生长不可预测，即使是小动脉瘤也有破裂风险。颅内动脉瘤（IA）破裂是一种灾难性事件，死亡率很高。有证据表明，吸烟与IA的形成和破裂密切相关。然而，吸烟对IA形成和破裂的生物学影响仍未得到充分体现。
本研究方案已在PROSPERO前瞻性注册，注册号为CRD42020203634。我们在PubMed和CNKI上进行了系统检索，以查找截至2021年12月发表的探索吸烟对颅内动脉瘤生物学影响的研究，并将所有研究纳入分析。使用RevMan软件进行数据分析。
本荟萃分析中，14篇原始文章共纳入6196例患者。当前吸烟组IA破裂的风险显著高于非吸烟组，具有统计学意义（RR = 1.23，95%：1.11 - 1.37）。通过敏感性分析消除队列间的异质性后，吸烟组和非吸烟组IA破裂风险仍存在统计学显著差异（RR总计 = 1.26，95%：1.18 - 1.34）。既往吸烟（戒烟）组和非吸烟组IA破裂风险无统计学显著差异（RR = 1.09，95%：0.50 - 2.38）。通过敏感性分析消除队列间的异质性后，既往吸烟（戒烟）组和非吸烟组IA破裂风险仍无统计学显著差异（RR总计 = 0.75，95%：0.47 - 1.19）。当前吸烟组IA破裂的风险显著高于既往吸烟（戒烟）组，具有统计学显著差异（RR = 1.42，95%：1.27 - 1.59）。
虽然吸烟对IA形成和破裂的生物学影响尚不清楚，但本研究表明当前吸烟是IA破裂的一个危险因素。戒烟对IA患者非常重要。
