哮喘联盟

   摘要
   目标：吸烟可增加胃食管反流症状(GERS)风险，但戒烟是否可改善GERS尚不清楚。本研究旨在阐明戒烟是否可改善GERS。
   方法：本研究基于Nord-Trøndelag健康研究（HUNT研究），一项1995-1997至2006-2009间，在挪威Nord-Trøndelag州进行的前瞻系人群基础队列研究。20岁以上的本州居民均被邀请。本研究纳入了29,610例报告有胃灼热或反酸的居民（反馈率61%）。采用逻辑回归评估戒烟率和GERS改善的相关性，结果为优势比(ORs)和95%可信区间(CIs)。分析采用抗反流治疗进行分层，结果经过性别、年龄、身体质量指数(BMI)、饮酒量、教育和身体锻炼因素校正。亚组分析还采用BMI进行分层。
   结果：在抗反流治疗至少每周1次的人群中，相比持续每日吸烟，戒除每日吸烟与GERS改善有关，GERS从严重到无/较小抱怨(校正OR 1.78; 95% CI: 1.07-2.97)。此相关性在BMI处于正常范围的人群存在，但在超重人群中不存在。在轻度GERS或抗反流治疗少于每周1次的人群中，戒烟与GERS状态无关。
   结论：戒烟与严重GERS改善有关，但此相关性只在BMI正常且使用抗反流治疗至少每周1次的人群中存在，在其他GERS人群中不存在。

（刘国梁 审校）
Am J Gastroenterol. 2013 Dec 10. doi: 10.1038/ajg.2013.414. [Epub ahead of print]

Tobacco Smoking Cessation and Improved Gastroesophageal Reflux: A Prospective Population-Based Cohort Study: The HUNT Study.

Ness-Jensen E, Lindam A, Lagergren J, Hveem K.

ABSTRACT
OBJECTIVES:Tobacco smoking increases the risk of gastroesophageal reflux symptoms (GERS), but whether tobacco smoking cessation improves GERS is unclear. The aim of this study was to clarify if tobacco smoking cessation improves GERS.
METHODS:The study was based on the Nord-Trøndelag health study (the HUNT study), a prospective population-based cohort study conducted from 1995-1997 to 2006-2009 in Nord-Trøndelag County, Norway. All residents of the county from 20 years of age were invited. The study included 29,610 individuals (61% response rate) who reported whether they had heartburn or acid regurgitation. The association between tobacco smoking cessation and improvement in GERS was assessed by logistic regression, providing odds ratios (ORs) with 95% confidence intervals (CIs). The analyses were stratified by antireflux medication, and the results were adjusted for sex, age, body mass index (BMI), alcohol consumption, education, and physical exercise. Subgroup analyses were also stratified by BMI.
RESULTS:Among individuals using antireflux medication at least weekly, cessation of daily tobacco smoking was associated with improvement in GERS from severe to no or minor complaints (adjusted OR 1.78; 95% CI: 1.07-2.97), compared with persistent daily smoking. This association was present among individuals within the normal range of BMI (OR 5.67; 95% CI: 1.36-23.64), but not among overweight individuals. There was no association between tobacco smoking cessation and GERS status among individuals with minor GERS or individuals using antireflux medication less than weekly.
CONCLUSIONS:Tobacco smoking cessation was associated with improvement in severe GERS only in individuals of normal BMI using antireflux medication at least weekly, but not in other individual with GERS.
 

Am J Gastroenterol. 2013 Dec 10. doi: 10.1038/ajg.2013.414. [Epub ahead of print]