吸烟对健康者肺功能的影响

目的：研究吸烟对人体肺功能的影响,提高人们早期戒烟意识。方法：应用MedGraphics 1085D肺功能仪（美国）对我院体检中心161例健康成年人进行肺功能检测,探讨吸烟对肺功能的影响。结果：吸烟组中FEV1、FVC、FEV1/FVC明显低于对照组（P〈0.05）;小气道功能指数FEF50%、FEF75%、MMEF显著降低（P〈0.01）。结论：健康吸烟者肺通气功能较非吸烟者有不同程度的下降,且以阻塞性通气功能及小气道功能损害为主;肺功能检查对气道疾病早期诊断具有重要意义。     

辽宁省六城市7515名吸烟人群的肺功能检测分析

目的 通过检测吸烟人群与非吸烟人群的肺功能,探讨吸烟对肺功能的影响.方法 对辽宁省6个城市26 324人采用统一问卷调查及体格检查,经筛选和剔除后,对无症状的7 515名吸烟者及6 469名非吸烟者进行问卷调查后的6个月内,由固定技师每隔2个月应用同型号肺功能仪检测肺功能,连续3次,取均值,并对测定结果进行比较分析.结果 吸烟组与非吸烟组间以及轻、中、重组间的功能残气量(ERV)、残气量(RV)、深吸气量(IC)、肺活量(VC)、RV/肺总量(TCL)的差异均无统计学意义(P值均＞0.05).肺通气功能比较:吸烟组的1秒钟用力呼气容积(FEV1)占预计值百分比、FEV1/用力呼气肺活量(FVC)占预计值百分比均较非吸烟组显著降低(P值均＜0.05),而MVV占预计值百分比和FVC占预计值百分比的差异均无统计学意义(P值均＞0.05);轻、中、重组间MVV占预计值百分比和FVC占预计值百分比的差异均无统计学意义(P值均＞0.05),而轻组与重组间FEV1占预计值百分比、FEV1/FVC占预计值百分比的差异均有统计学意义(P值分别为＜0.01、0.05),中组与重组间FEV1:占预计值百分比的差异有统计学意义(P＜0.05).吸烟组反应小气道功能[25%呼气流速(FEF 25%)、50%呼气流速(FEF 50%)、75%呼气流速(FEF 75%)、中段呼气流速(MMEF)]的各项指标均较非吸烟组显著增高(P值分别＜0.05、0.01);轻组与重组间FEF 25%、FEF 50%、FEF 75%的差异均有统计学意义(P值均＜0.05),轻组与重组间MMEF的差异有统计学意义(P＜0.01).结论 吸烟者在尚无临床症状时,其肺通气功能已降低,随着吸烟年限和数量的增加,肺功能的损害也越严重.     

中老年男性戒烟后肺功能改善与一氧化氮含量变化的相互关系

目的 观察中老年男性戒烟10年者和吸烟10年以上者及同龄不吸烟健康者的肺功能情况与一氧化氮含量之间的关系。方法 筛选24名健康男性吸烟者。按1：1配对筛选24名健康同龄男性戒烟者（戒烟时间达10年以上）,24名健康同年龄男性不吸烟者。受试者在1个月内每10天做1次肺功能,血清NO含量测定,连续3次。结果 吸烟10年以上者与不吸烟者、戒烟10年以上者肺功能相比,肺活量（VC）、用力肺活量（FVC）、一秒钟用力呼气容积（FEV1）及残气量（RV）、残气量／肺总量（RV／TLC）有显著性差异;一秒钟用力呼气容积与用力肺活量之比（FEV1／FVC）、最大通气量（MMV）、最大呼气中期流量（MMEF）、功能残气量（FRC）、肺总量（TLC）有显著差异;血清NO含量变化有显著性差异。戒烟10年以上者与健康不吸烟者肺功能相比,VC、FVC、TLC、FEV1无显著性差异;RV、RV／TLC、FRC、MMV、MMEF有显著性差异;血清NO含量变化无显著性差异。结论 长期大量吸烟可严重损害肺通气功能并形成某些不可逆病理变化,戒烟10年后仍不能完全消除吸烟对肺功能的损害。     

中老年男性戒烟后肺功能改善与一氧化氮含量变化的相互关系

目的观察中老年男性戒烟10年者与吸烟10年以上者及同龄不吸烟健康者的肺功能情况与一氧化氮含量之间的关系.方法筛选24名健康男性吸烟者.按1∶1配对筛选24名健康同龄男性戒烟者(戒烟时间达10年以上),24名健康同年龄男性不吸烟者.受试者在1个月内每10天做1次肺功能、血清NO含量测定,连续3次.结果吸烟10年以上者与不吸烟者、戒烟10年以上者肺功能相比,肺活量(VC)、用力肺活量(FVC)、一秒钟用力呼气容积(FEV1)及残气量(RV)、残气量/肺总量(RV/TLC)有显著性差异;一秒钟用力呼气容积与用力肺活量之比(FEV1/FVC)、最大通气量(MMV)、最大呼气中期流量(MMEF)、功能残气量(FRC)、肺总量(TLC)有显著差异;血清NO含量变化有显著性差异.戒烟10年以上者与健康不吸烟者肺功能相比,VC、FVC、TLC、FEV1无显著性差异;RV、RV/TLC、FRC、MMV、MMEF有显著性差异;血清NO含量变化无显著性差异.结论长期大量吸烟可严重损害肺通气功能并形成某些不可逆病理变化,戒烟10年后仍不能完全消除吸烟对肺功能的损害.     

儿童肺炎支原体肺炎肺功能改变及临床意义的探讨

目的:探讨儿童肺炎支原体肺炎（MPP）肺功能改变情况及临床意义。方法:收集114例社区获得性肺炎（CAP）患儿,根据是否MP感染分为MPP组70例、非MPP组44例;选取同期健康体检儿童42例（对照组）,年龄6～14岁。入院后采用意大利MIR spirolab Ⅲ肺功能仪测定用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、1秒率（FEV1/FVC）、最大呼气流量（PEF）、最大呼气中期流量（MMEF）、用力呼出25%肺活量时瞬间流量（FEF25）、用力呼出50%肺活量时瞬间流量（FEF50）、用力呼出75%肺活量时瞬间流量（FEF75）,其中43例MPP组患儿、24例非MPP组患儿均于临床恢复期（病程第4周）复查肺功能。结果:MPP组急性期肺功能各项指标（FVC、FEV1%、FEV1/FVC、MMEF、FEF25、FEF50、FEF75）较对照组明显下降,差异有统计学意义（P＜0.05）;非MPP组急性期FVC、FEV1%、FEF50、FEF75较对照组下降,差异有统计学意义（P＜0.05）,而MPP组MMEF、FEF50、FEF75 较非MPP组下降更为明显,差异有统计学意义（P＜0.05）;非MPP组恢复期肺功能大小气道指标均恢复正常,差异有统计学意义（P＜0.05）;MPP组恢复期肺功能FVC、FEV1%、FEV1/FVC较急性期均恢复正常,差异有统计学意义（P＜0.05）,而MMEF、FEF50、FEF75略有升高,其中FEF50、FEF75仍低于65%,且差异无统计学意义（P>0.05）。结论:儿童CAP急性期大小气道均有不同程度损伤,非MPP患儿于恢复期大小气道通气功能均恢复正常,MPP患儿小气道受损更为明显,改善缓慢,恢复期仍存在一定程度气道受限。     

89例2型糖尿病患者肺功能改变观察

目的：观察2型糖尿病（2TDM）患者肺通气功能的改变情况,并对其改变机制进行探讨。方法：选择2006年3月～2009年10月我院门诊和住院的2TDM患者89例,设为2TDM,将我院的健康体检者89例设为对照组。对两组患者采用比利时麦迪HYP＇Air Micro5000型肺功能仪测定肺总量（TLC）、肺活量（VC）、用力肺活量（FVC）、1s用力呼气量（FEV1）、最大通气量（MVV）、25%用力呼气流量（FEF25）和50%用力呼气流量（FEF50）、动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）和血氧饱和度（SaO2）,并对两组进行比较,观察2TDM患者肺通气功能的改变情况。结果：2TDM组患者肺功能指标FVC、FEV1、FEF25、FEF50、PaO2均明显低于对照组（P〈0.01）;有并发症的2TDM组FVC、FEV1、FEF25和FEF50均明显低于无并发症的（P〈0.05）。结论：2TDM患者肺功能有明显改变,存在不同程度的通气功能障碍,监测肺功能指标有助于判定2TDM患者肺功能损伤的情况,并指导临床治疗。     

2型糖尿病患者肺功能改变的临床观察

目的 探讨2型糖尿病（2TDM）患者肺通气功能异常的临床意义.方法 采用日本SPIROANL YEERST2300型电子肺功能仪测定肺功能各项指标：肺总量（TLC）、用力肺活量（FVC）、1秒用力呼气量（FEV1）、肺活量（VC）、最大通气量（MVV）、25%用力呼气流量（FEF25）和50%用力呼气流量（FEF50）占预计值百分比.同时测定动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）和血氧饱和度（SaO2）.结果 2型糖尿病组患者PaO2明显低于正常组（P＜0.05）,肺功能指标FVC、FEVl、FEF25和FEF50均明显低于正常组（P＜0.01）;2型糖尿病有合并症组FVC、FEVl、FEF25和FEF50均明显低于无合并症组（P＜0.05）.结论 2TDM患者存在不同程度的通气功能障碍,以阻塞性通气功能障碍为主,早期监测肺功能指标对2TDM患者肺损伤的预防和治疗可能有一定意义.     

哮喘缓解期患儿小气道功能的监测及临床意义

【摘要】目的 监测哮喘缓解期患儿小气道功能变化并分析其临床意义。方法 选取2013年1月~2015年12月期间收治的100例哮喘缓解期患儿为观察组作为研究对象,并选取同一时期健康儿童50例作为对照组,所有受试者均接受肺功能检查。观察组患儿检查后接受6个月的观察并根据发作情况进行分级,比较不同患儿的大气道功能指标用力肺活量（FVC）、最大呼气流量（PEF）、第1秒用力呼气量（FEV1）及FEV1/FVC）和小气道功能指标最大呼气中期流速（MMEF75/25）、不同呼吸量的瞬间流速（FEF）25、50及75。结果 与对照组相比,观察组患儿的FVC、PEF、FEV1及FEV1/FVC无明显变化（P＞0.05）,MMEF75/25、FEF25、FEF50及FEF75显著降低（P＜0.05）;两组儿童的FVC、PEF、FEV1及FEV1/FVC比较差异无统计学（P＞0.05）,MMEF75/25、FEF25、FEF50及FEF75的差异具有统计学意义（P＜0.05）。结论 哮喘缓解期患儿仍存在小气道功能受损,小气道功能监测对患儿发作风险具有提示作用。     

吸烟对无呼吸道症状中老年人肺通气功能的影响

目的探讨吸烟对无呼吸道症状的中老年人肺功能的影响。方法选取该院2010年9月-2011年6月健康体检的中老年人120例,其中吸烟者80例,非吸烟者40例,分别测定并比较两组的肺通气功能结果。结果吸烟组MMEF％、FEF75％较非吸烟组明显降低（P〈0．05）;而FEVI％、FEVl／FVC、PEF％、FVC％、FEF25％在两组间差异无统计学意义（JP〉0．05）。并且MMEF％与吸烟量（年包数）呈显著负相关（相关系数r=-0．342,P〈0．05）。结论吸烟可增加中老年人小气道阻力,吸烟量越多,小气道阻力越高。     

烧伤合并吸入性损伤病人的肺功能检测

报道了36例烧伤病人的肺功能检测，结果：（1）中等面积，大面积烧伤和体表烧伤合并吸入性损伤患者用力肺活量（FVC），第1秒时间肺活量（FEV1.0，呼出50%肺活量时的呼气流速（FEF50%），呼出75%用力肺活量时的呼气流速（FEF75%）降低，于伤后50h降至最低值；（2）中等烧伤面积组伤后10d时FVC，FEV1.0，FEF50%，FEF75%有所回升；至伤后30d恢复正常；（3）大面积烧伤和体表烧伤合并吸入性损伤组伤后50h和10d均明显降低；伤后30d有所升高，除大面积烧伤组FVC伤后30d时FVC已恢复正常外，均未达到正常范围；（4）体表烧伤合并吸入性损伤组的各时点所观察的肺功能参数下降较大面积烧伤组更为明显，采用微型肺量计检测对监护烧伤病人肺功能具有一定临床意义。     

Transfer factor in smokers and non-smokers after smoking two cigarettes

Impairments of lung functionality as long-term effects of cigarette smoking have been well established. To our knowledge, no study on acute recovery patterns in any important lung function index after smoking a very limited number of cigarettes has ever been reported. The present study reports recovery patterns of lung transfer factor (TF) and related parameters in smokers and non-smokers who smoked two Camel cigarettes. Lung transfer factor and other indices were determined by the single breath-holding technique. From our results, the TF and related indices of healthy Malaysians are similar to previously published normals of comparable age. On smoking two cigarettes, male smokers began to recover from the 30th minute; male non-smokers had not begun recovery even by the 50th minute. Extrapolation of the recovery curves suggests that a "safer" interval between cigarettes for male smokers is about 114 minutes.     

Respiratory effects of non-tobacco cigarettes

Data from the Tucson epidemiological study of airways obstructive disease on smoking of non-tobacco cigarettes such as marijuana were analysed to determine the effect of such smoking on respiratory symptoms and pulmonary function. Among adults aged under 40, 14% had smoked non-tobacco cigarettes at some time and 9% were current users. The prevalence of respiratory symptoms was increased in smokers of non-tobacco cigarettes. After tobacco smoking had been controlled for men who smoked non-tobacco cigarettes showed significant decreases in expiratory flow rates at low lung volumes and in the ratio of the forced expiratory volume in one second to the vital capacity. This effect on pulmonary function in male non-tobacco cigarette smokers was greater than the effect of tobacco cigarette smoking. These data suggest that non-tobacco cigarette smoking may be an important risk factor in young adults with respiratory symptoms or evidence of airways obstruction.     

Cigarette smoking decreases dynamic inspiratory capacity during maximal exercise in patients with type 2 diabetes

To investigate the influence of cigarette smoking on exercise capacity, respiratory responses and dynamic changes in lung volume during exercise in patients with type 2 diabetes. Forty-one men with type, 2 diabetes without cardiopulmonary disease were recruited and divided into 28 non-current smokers and 13 current smokers. All subjects received lung function tests and cardiopulmonary exercise testing using tracings of the flow-volume loop. Exercise capacity was compared using the percentage of predicted oxygen uptake at maximal workload (%VO2max). Respiratory variables and inspiratory capacity (IC) were compared between the two groups at rest and at 20%, 40%, 60%, 80% and 100% of maximum workload. Although there was no significant difference in lung function tests between the two groups, venous carboxyhemoglobin (CO-Hb) levels were significantly higher in current smokers. %VO2max was inversely correlated with CO-Hb levels. Changing patterns in respiratory rate, respiratory equivalent and IC were significantly different between the two groups. Current smokers had rapid breathing, a greater respiratory equivalent and a limited increase in IC during exercise. Cigarette smoking diminishes the increase in dynamic IC in patients with type 2 diabetes. As this effect of smoking on dynamic changes in lung volume will exacerbate dynamic hyperinflation in cases complicated by chronic obstructive pulmonary disease, physicians should consider smoking habits and lung function when evaluating exercise capacity in patients with type 2 diabetes.     

长期吸烟对健康成人血脂和血糖的影响

为探讨长期吸烟对空腹血脂、血糖、胰岛素及胰岛素敏感性指标的影响及其变化规律,在８２例健康成人通过多元逐步回归分析,探讨长期吸烟对血脂、血糖、胰岛素及胰岛素敏感性指标影响的显著性及影响程度;并以协方差分析校正其它影响因素后,对比分析长期吸烟者与不吸烟者血脂、血糖、胰岛素及胰岛素敏感性指标的差异程度。结果：长期吸烟者伴随有糖代谢及脂代谢指标异常变化。并与吸烟程度有显著性相关关系。校正其它可能影响的因素     

Cigarette Smoking and Platelet Aggregation

The influence of cigarette smoking on platelet aggregation was studied in habitual and non-habitual smokers. The results indicate that habitual smokers have a greater tendency to platelet aggregation than do non-habitual smokers. Acute effects of cigarette smoking were, however, not significant. The nucleotide content and the serotonin content of the platelets were analyzed. The adenosine nucleotide and serotonin contents were similar in smokers and non-smokers in the control state and neither showed significant changes on cigarette smoking. There were significant correlations between the control concentrations of the various nucleotides in both groups and there were even higher correlations after smoking. Platelet aggregation bore no demonstrable relationship to the nucleotide or serotonin contents of the platelet. We conclude that the long-term effect of smoking is probably more important than the acute effect.     

Smoking and death rates: report on forty-four months of follow-up of 187,783 men. 2. Death rates by cause

Information was gathered on the smoking habits of 187,783 white men between the ages of 50 and 69 between January 1 and May 31, 1952. The men were subsequently traced through October 31, 1955. 11,870 men died during this period. The total experience covered 667,753 man years. For microscopically proved cases of cancer and for the total cases reported as cancer it was found that the death rates were higher among regular cigarette smokers than among men who never smoked, that the mortality ratio increased with the number of cigarettes smoked each day, and that the death rates were higher among pipe and cigar smokers than among men who never smoked. 7316 deaths occurred among regular cigarette smokers; this was an excess of 2665 over the 4651 deaths that would have occurred had the age-specific death rates for smokers been equal to that for nonsmokers. Coronary disease accounted for 52.1% of the excess; lung cancer accounted for 13.5% of the excess; and cancer of other sites accounted for 13.5% of the excess. An extremely high association between cigarette smoking and death rates for men with lung cancer was found in both rural areas and large cities. Only 338 deaths were ascribed to pulmonary diseases other than lung cancer. Only 1120 (9.4%) of the 11,870 deaths were attributed to diseases other than cancer, cardiac, circulatory, and pulmonary diseases and accidents, violence, and suicide. Only 3 of the specific disease entities - gastric and duodenal ulcers and cirrhosis of the liver - showed a statistically significant degree of association with smoking habits. The most important finding of this study was the high degree of association between cigarette smoking and the total death rate.     

Dose-related effects of cigarette smoking on olfactory function

Little is known about the influence of cigarette smoking on the ability to smell; previous studies on this topic have led to contradictory findings and have failed to take into account smoking dose and duration. In the present study, the 40-odorant University of Pennsylvania Smell Identification Test was administered to 638 subjects for whom detailed smoking histories were available. Smoking was found to be adversely associated with odor identification ability in a dose-related manner in both current and previous cigarette smokers. Among previous smokers, improvement in olfactory function was related to the time elapsed since the cessation of smoking. Logistic regression analysis found current smokers to be nearly twice as likely to evidence an olfactory deficit than persons who have never smoked. Overall, the data suggest that (1) smoking causes long-term but reversible adverse effects on the ability to smell and (2) the failure of some studies to demonstrate smoking effects may be caused by the inclusion of persons with a history of smoking in the nonsmoking groups.     

Chronic airflow obstruction. Evolution of disordered function in cigarette smokers

Measurements of the mechanical behaviour of the lung, which reflect lung structure, have been used to elucidate the evolution of chronic airflow obstruction in male cigarette smokers and subjects with pulmonary emphysema. The exponent K, from a single exponential function fitted to static pressure-volume data, is an index of lung distensibility directly related to the size of peripheral airspaces. Elastic recoil pressure is inversely related to K. Conductance measured during forced and interrupted deflations of the lungs reflects the dimensions of airways. K increased abnormally with age in smokers suggesting an increase in the airspace size caused by the effects of cigarette smoke which probably acts by intensifying elastase activity in lung tissue. Decreased conductance implying narrowing of airways is found in young smokers, but conductance rises and airways become more distensible in older smokers. A progressive increase in K (with decrease in recoil pressure) and a decrease in conductance are responsible for the advancement of severe airflow obstruction in cigarette smokers.     

Cigarette smoking among school teachers in Tobago

Tobago, until lately, was considered a society with a low prevalence of cigarette smoking. Recent surveys, however, showed an increasing smoking prevalence among school children. To assess whether teachers in Tobago can be credible role models for their pupils, we carried out a cross-sectional survey on their smoking-related attitudes and behaviour in 2002. We distributed anonymous, structured questionnaires to teachers of all 52 primary and secondary schools in the island and conducted structured observations in schools. Of 579 teachers present during the survey, 559 (97%) returned a completed questionnaire; 8.6% of the male and 2.4% of the female teachers reported to be current cigarette smokers; slightly higher proportions had ever been daily smokers. Teachers were well aware of the harmful effects of smoking. Significantly more non-smokers than current smokers were in favour of strict school smoking regulations. The vast majority of the teachers perceived anti-smoking education as their duty. None of the schools had dedicated smoking rooms for teachers, and we found no cigarette butts in or around teachers' rooms. In Tobago, teachers have a lower reported prevalence of cigarette smoking than their pupils. Thus, most teachers can be credible role models with regard to smoking prevention and should be encouraged to become more active in school-based preventive activities.