终生和吸烟对颅内动脉瘤破裂状态、数量和大小的影响

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-04-30 DOI:10.1016/j.clineuro.2025.108924

Ramazan Jabbarli , Marvin Darkwah Oppong , Meltem Gümüs , Mehdi Chihi , Thiemo Florin Dinger , Laurèl Rauschenbach , Yahya Ahmadipour , Philipp Dammann , Yan Li , Nika Guberina , Karsten H. Wrede , Ulrich Sure

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引用次数: 0

摘要

吸烟对颅内动脉瘤（IA）发生影响的定量数据很少。我们的目的是分析终生和当前吸烟暴露与IA特征之间的关系。方法在这项前瞻性观察队列研究中（2016年7月- 2023年1月，n = 918），所有患者或近亲填写吸烟习惯评估问卷，包括吸烟状态（无/曾经/现在）和消费水平（重度吸烟者vs轻度吸烟者[≥/<；10支/天]，以及以包年为单位的终生暴露量）。研究终点是破裂状态、大小和多发IA的存在。结果不吸烟者、曾经吸烟者、轻度吸烟者和重度吸烟者的分布分别为23.2% %、25.6% %、11.2% %和40% %。平均终生吸烟暴露量为20包年。吸烟者在出现破裂的风险更高(调整优势比(aOR) = 1.71, 95 %可信区间[CI] = 1.29 - -2.26, p & lt; 0.0001),大(≥7 mm, aOR = 1.41, 95 % CI = 1.05 - -1.89, p = 0.022)和多个IA (aOR = 1.34, 95 % CI = 1.01 - -1.77, p = 0.045)。在曾经吸烟者的亚组分析中，重度吸烟增加了IA破裂的风险（aOR=1.83, 95 % CI= 1.33-2.50, p <； 0.0001）和较大的吸烟（aOR=1.65, 95 % CI= 1.19-2.30, p = 0.003）。最后，较长的吸烟史（20包年）与较高的多重风险（aOR=1.61, 95 % CI= 1.21-2.13, p = 0.001）和较大的IA （aOR=1.40, 95 % CI= 1.04-1.87, p = 0.025）相关。结论sour数据强调了吸烟在IA发生中的作用，以及戒烟对预防破裂的重要性。目前特别是大量吸烟增加内源性动脉破裂的风险，而多年的慢性暴露更有可能导致多发和大的内源性动脉破裂。

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Impact of lifetime and current smoking exposure on the rupture status, number, and size of intracranial aneurysms

Background

Quantitative data on the impact of smoking on genesis of intracranial aneurysms (IA) is sparse. We aimed to analyze the association between lifetime and current smoking exposure and IA characteristics.

Methods

In this prospective observational cohort study (07/2016–01/2023, n = 918), all patients or next of kin filled out the questionnaire for assessment of smoking habits including the status (no/former/current) and consumption level (heavy vs light current smoker [≥/<10 cigarettes/day], and lifetime exposure in pack-years). The study endpoints were the ruptured status, size, and presence of multiple IA.

Results

The distribution of non-, former, light, and heavy smokers was 23.2 %, 25.6 %, 11.2 % and 40 % respectively. The median lifetime smoking exposure was 20 pack-years. Current smokers were at higher risk of presenting with ruptured (adjusted odds ratio [aOR]=1.71, 95 % confidence interval [CI]=1.29–2.26, p < 0.0001), large (≥7 mm, aOR=1.41, 95 % CI=1.05–1.89, p = 0.022) and multiple IA (aOR=1.34, 95 % CI=1.01–1.77, p = 0.045). In the subgroup analysis among ever smokers, heavy smoking additionally increased the risk of IA rupture (aOR=1.83, 95 % CI=1.33–2.50, p < 0.0001) and larger size (aOR=1.65, 95 % CI=1.19–2.30, p = 0.003). Finally, longer history of smoking (>20 pack-years) was related to higher probability of multiple (aOR=1.61, 95 % CI=1.21–2.13, p = 0.001) and large IA (aOR=1.40, 95 % CI=1.04–1.87, p = 0.025).

Conclusions

Our data underline the role of smoking in IA genesis, and the importance of smoking cessation for rupture prevention. Current and particularly heavy smoking increases the risk of IA rupture, whereas the chronic exposure over years more likely results in the development of multiple and large IA.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.