Ernst E
Klinik für Physikalische Medizin und Rehabilitation, AKH, Wien, Austria.
Br J Rheumatol. 1993 Mar;32(3):239-42. doi: 10.1093/rheumatology/32.3.239.
Epidemiological studies strongly imply that smoking may be a risk factor for back problems. It has been speculated that this is due to frequent coughing, unhealthy life style or osteoporosis in smokers. All of these hypotheses, however, do not accord with the experimental evidence. A new theory is therefore proposed. It suggests that smoking leads to malnutrition of the disc which in turn renders it more vulnerable to mechanical stress. Malnutrition can be brought about by carboxyhaemoglobin formation, nicotine-induced vasoconstriction, arteriosclerotic vessel wall changes, impairment of fibrinolytic activity and changes in the flow properties of blood. The evidence supporting these pathomechanisms is discussed. Future studies should test the above hypothesis experimentally.
流行病学研究有力地表明，吸烟可能是背部问题的一个风险因素。据推测，这是由于吸烟者频繁咳嗽、不健康的生活方式或骨质疏松症所致。然而，所有这些假设都与实验证据不符。因此，提出了一种新理论。该理论认为，吸烟会导致椎间盘营养不良，进而使其更容易受到机械应力的影响。营养不良可能由碳氧血红蛋白的形成、尼古丁引起的血管收缩、动脉硬化的血管壁变化、纤溶活性受损以及血液流动特性的改变所致。文中讨论了支持这些发病机制的证据。未来的研究应通过实验来验证上述假设。
