长期被动吸烟对北京社区居民呼吸系统的影响

目的：调查长期被动吸烟对北京市社区居民肺功能、呼吸系统症状、慢性气道疾病及气道炎症的影响。方法入组北京市西城区35岁以上不吸烟居民835例,其中长期被动吸烟组380例(45.5%),对照组455例。采用调查问卷方式,了解受试者基本信息、慢性呼吸系统症状情况、呼吸系统疾病状况。检测所有受试者肺通气功能,包括FEV1和FEV6；采集血样、呼出气冷凝液(EBC),检测血清肺泡表面活性蛋白D(SPD),EBCpH值及IL-6水平。比较2组受试者上述指标的差异,并采用回归分析方法评价被动吸烟时间对肺功能、呼吸系统症状及疾病的影响；采用Spearman相关检验评价被动吸烟时间与血清SPD、EBCpH及IL-6的相关性。结果被动吸烟组年龄低于对照组,女性所占比例高于对照组。被动吸烟组FEV1%pred显著低于对照组,多元线性回归提示被动吸烟时间与FEV1呈负相关。被动吸烟组呼吸症状及气道疾病比例均略高于对照组,但差异无统计学意义,Logistic回归显示,被动吸烟时间是慢性咳嗽(OR=1.243,95%CI：1.058~1.459)及慢性支气管炎(OR=1.326,95%CI：1.031~1.704)的危险因素。被动吸烟组EBCpH略低于对照组,2组间SPD、EBCIL-6无明显差异；被动吸烟组中,被动吸烟时间与血清SPD水平呈正相关。结论北京市城区居民中,被动吸烟者FEV1%pred偏低、气道炎症指标偏高,并且这种改变随暴露时间增加而加重；慢性咳嗽及慢性支气管炎患病率随被动吸烟时间延长而增加。

The impacts of long-term second-hand smoke exposure on the respiratory system of residents in Beij ing

Objective To investigate the impacts of long-term second-hand smoke exposure on the respiratory system of residents in Beijing,including lung function,respiratory symptoms,chronic airway diseases and airway inflammation.Methods Eight hundred and thirty-five non-smoking residents over 35 years old of Xicheng District in Beijing were enrolled.Three hundred and eighty(45.5%) subjects had long term exposure to second-hand smoke.Questionnaires were used to investigate basic information chronic respiratory symptoms and respiratory diseases.Lung function including FEV1 and FEV6 were tested.EBC and blood were collected for the measurement of EBC pH,IL-6 and serum SPD.We compared these indices between the exposure group and control group,and also used regression analysis to assess the impacts of exposure duration on lung function,respiratory symptoms and diseases.Correlation between exposure duration and inflammation biomarkers was assessed using Spearman correlation test.Results Subj ects in the exposure group were significantly younger and had a higher proportion of females.FEV1%pred was significantly lower in the exposure group and regression analysis indicated that FEV1 was lower with longer exposure duration.The exposure group had a higher prevalence of respiratory symptoms and diseases,but with no statistical difference.Logistic regression analysis showed that prevalence of chronic cough and chronic bronchitis increased with exposure duration,with OR of 1.243(95%CI :1.058,1.459) and 1.326(95%CI :1.031,1.704)respectively.The exposure group had slightly lower EBC pH,whereas EBC IL-6 and serum SPD did not differ between two groups.In the exposure group,exposure duration was positively correlated with serum SPD.Conclusions Residents in Beijing exposed to second-hand smoke had lower FEV1%pred and higher airway inflammation biomarkers,and the impacts seemed to be more evident with longer exposure duration.The prevalence of chronic cough and chronic bronchitis also increased with exposure duration.