摘要：

研究背景 既往研究提示吸烟可以增加多发性硬化发病风险，但与视神经脊髓炎谱系疾病发病风险的关联性研究少见，本研究探讨吸烟与多发性硬化和视神经脊髓炎谱系疾病发病风险的关联性，以探讨吸烟是否增加上述两种疾病的发病风险。方法 采用调查问卷和电话随访方式记录53 例多发性硬化患者、62 例视神经脊髓炎患者和85 例正常对照者的吸烟暴露情况，包括开始吸烟年龄、吸烟持续时间、每日吸烟量和累积吸烟量，以及受试者配偶、父母是否吸烟，是否存在职业暴露。结果 最终获得有效调查问卷和电话随访者156 例（包括39 例多发性硬化患者、43 例视神经脊髓炎谱系疾病患者和74 例正常对照者），与不主动吸烟者（被动吸烟和不吸烟）相比，主动吸烟者发生多发性硬化（OR = 10.800，95%CI：2.202 ~ 52.975；P = 0.001）和视神经脊髓炎谱系疾病（OR = 5.838，95%CI：1.123 ~ 30.357；P = 0.050）的风险增加；与不吸烟者相比，吸烟者（主动吸烟和被动吸烟）发生多发性硬化（OR = 3.444，95%CI：1.491 ~ 7.953；P = 0.003）和视神经脊髓炎谱系疾病（OR = 2.370，95%CI：1.039 ~ 5.407；P = 0.038）的风险增加；与男性不吸烟者相比，男性吸烟者仅多发性硬化的发病风险增加（OR = 15.000，95%CI：2.239 ~ 100.483；P = 0.005）。结论 吸烟可以增加多发性硬化的发病风险，但是否增加视神经脊髓炎谱系疾病的发病风险尚不明确。

关键词: 吸烟, 多发性硬化, 视神经脊髓炎, 危险因素

Abstract:

Background  Previous studies showed that smoking is associated with increased multiple sclerosis (MS) susceptibility, while investigation of relation between smoking and risk of neuromyelitis optica spectrum disorders (NMOSDs) is rarely reported. Hence, this study aims to explore the association of smoking with MS and NMOSDs susceptibility and ascertain whether smoking can increase the risk of these two diseases.  Methods  Fifty-three MS patients, 62 NMOSDs patients and 85 healthy individuals were enrolled in this study. Standardized questionnaire or follow-up by telephone call were adopted to collect information regarding whether patients, healthy controls and their relatives have smoking behavior, and to learn circumstances of active smoking and passive smoking in these subjects. Results  There were 156 subjects who finished effective questionnaires and telephone follow-up, including 39 MS patients, 43 NMOSDs patients and 74 controls. Compared with passive smoking and non-smoking subjects, the susceptibility of both MS (OR = 10.800, 95%CI: 2.202-52.975; P = 0.001) and NMOSDs (OR = 5.838, 95%CI: 1.123-30.357; P = 0.050) was significantly increased in active smoking subjects. Compared with non-smoking subjects, the susceptibility of both MS (OR = 3.444, 95% CI: 1.491-7.953; P = 0.003) and NMOSDs (OR = 2.370, 95%CI: 1.039-5.407; P = 0.038) was significantly increased in active and passive smoking subjects. In comparison with non-smoking males, smoking males were susceptible to MS (OR = 15.000, 95%CI: 2.239-100.483; P = 0.005).  Conclusions  Smoking is definitely the risk factor for MS, whereas it is not clear whether it is a risk factor for NMOSDs.

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