目的：评价戒烟对RA患者疾病活动度的影响。

　　方法：1992至2005年期间，2800例成人患者纳入了瑞典BARFOT早期RA研究。患者纳入研究时和随访2年，5年和8年时均登记疾病活动度评分（DAS28），C反应蛋白（CRP），健康评分问卷（HAQ）,类风湿因子（RF），抗CCP抗体，整体健康和疼痛视觉模拟评分（VAS）,EULAR反应和治疗方案。2010年，对2102例患者进行问卷调查，调查其生活方式相关指标，包括是否戒烟。

　　结果：本研究共纳入病程小于2年的RA患者1460例。2010年，吸烟的患者占17%。共有127例患者在纳入研究后戒烟。在控制了基线时年龄，病程，性别，社会经济因素，吸烟状态，RF和DAS28等因素后，纳入研究后戒烟与8年时EULAR反应良好负相关(OR 0.44, 95% CI 0.22-0.86, p=0.02)。

　　结论：在这个大型的瑞典RA患者队列中，2010年吸烟患者占17%。发生RA后戒烟并不能改变吸烟的RA患者预后不良的结局，但是所有RA患者均应该戒烟，因为吸烟容易使心血管疾病发生风险增加，并且与RA患者的血管炎和皮下结节密切相关。

　　附原文：Abstract：OBJECTIVE: We studied the effect of stopping smoking on disease activity in patients with RA.METHODS:Between 1992 and 2005, 2,800 adult patients were included in the BARFOT early RA study in Sweden. Disease Activity Score 28 joints (DAS28), C-reactive protein (CRP), Health Assessment Questionnaire (HAQ), rheumatoid factor (RF), anti-CCP, general health and pain visual analog scales (VAS), EULAR response and treatment were registered at inclusion and at follow-up 2, 5 and 8 years. In 2010, a self-completion postal questionnaire was sent to 2,102 patients, enquiring about lifestyle. factors, including cessation of smoking.RESULTS: A total of 1,460 adult RA patients with disease duration ≤2 years were included in this study. Seventeen percent smoked in 2010. In total, 127 patients stopped smoking after inclusion in the study. Smoking cessation after inclusion in the study was negatively associated with EULAR good outcome at 8 years (OR 0.44, 95% CI 0.22-0.86, p=0.02), controlled for age, disease duration, sex, socioeconomic class, smoking status, RF, and DAS28 at inclusion.CONCLUSION:Seventeen percent of the RA patients smoked in 2010 in this large Swedish RA cohort. Stopping smoking after onset of RA did not change the poor prognosis of smokers with RA, but all RA patients need to stop smoking because of the high risk of cardiovascular mortality and morbidity and the association of smoking with vasculitis and noduli in RA.

　　引自：Andersson ML, Bergman S, S derlin MK. The Effect of Stopping Smoking on Disease Activity in Rheumatoid Arthritis (RA). Data from BARFOT, a Multicenter Study of Early RA. Open Rheumatol J.2012;6:303-309. Epub 2012 Oct 19.