吸烟加剧慢性酒精性胰腺炎疾病的进展

作     者：Maisonneuve P Lowenfels A.B Mllhaupt B. 李翔 

作者机构：Epidemi ology Unit European Institute of Oncology Via Ripamonti 435 20141 Milan Italy.Dr 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第8期

页      面：43-43页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：慢性胰腺炎 胰腺钙化 胰腺肿瘤 比例危险率模型 临床中心 发病年龄 回顾性队列研究 发病风险 

摘      要：Background: Smoking is a recognised risk factor for pancreatic cancer and has been associated with chronic pancreatitis and also with type II diabetes. Aims: The aim of this study was to investigate the effect of tobacco on the age of dia gnosis of pancreatitis and progression of disease, as measured by the appearance of calcification and diabetes. Patients: We used data from a retrospective coho rt of 934 patients with chronic alcoholic pancreatitis where information on smok ing was available,who were diagnosed and followed in clinical centres in five co untries. Methods: We compared age at diagnosis of pancreatitis in smokers versus non-smokers, and used the Cox proportional hazards model to evaluate the effec ts of tobacco on the development of calcification and diabetes, after adjustment for age, sex, centre, and alcohol consumption. Results: The diagnosis of pancre atitis was made, on average, 4.7 years earlier in smokers than in non-smokers ( p = 0.001). Tobacco smoking increased significantly the risk of pancreatic calci fications(hazard ratio (HR) 4.9 (95%confidence interval (Cl) 2.3-10.5)for smok ers v non-smokers) and to a lesser extent the risk of diabetes (HR 2.3 (95%Cl 1.2-4.2)) during the course of pancreatitis. Conclusions: In this study, tobacc o smoking was associated with earlier diagnosis of chronic alcoholic pancreatiti s and with the appearance of calcifications and diabetes,independent of alcohol consumption.