吸烟对健康成年男性肺功能的影响

目的 探讨吸烟对健康成年男性肺功能的影响,督促吸烟者尽早戒烟.方法 采用日本美能AS-505型全自动便携式电脑化肺功能仪对201例健康成年男性进行肺功能检测,分析不同程度吸烟量对肺功能的影响.结果 各项肺功能检测指标中,肺容量指标和是否吸烟及吸烟量无明显关系;与不吸烟患者相比,吸烟患者肺通气功能(第1秒用力呼气容积、每分最大通气量、一秒率)以及小气道指标(最大呼气流速、用力呼气中期流速)均明显降低,其差异有统计学意义(P＜0.05或＜0.01),并且其损害程度与吸烟指数成正比.结论 吸烟影响肺功能,吸烟者在尚无临床症状时,其肺通气功能已明显降低,尤其以小气道功能受损最为明显.     

吸烟对健康成年人肺功能的影响

目的探讨吸烟对健康人体肺功能的影响,督促吸烟者尽早戒烟.方法采用便携式肺功能仪对220名健康成年男性进行肺功能检测,分析吸烟及不同程度吸烟量对肺功能的影响.结果各项肺功能检测指标中,肺容量指标和吸烟与否以及吸烟量无明显关系;和不吸烟组相比,吸烟组部分肺通气功能(FEV1、MVV、FEV/FCV)以及全部小气道功能(PEF、FEF 25%、FEF 50%、FEF 75%、MMEF 75/25)均明显降低,其差异有统计学意义分别为P＜0.05和P＜0.01,并且其损害程度与吸烟指数成正比.结论吸烟者在尚无临床症状时,其肺通气功能已明显降低,尤其以小气道功能受损最为严重.     

135例吸烟患者肺功能检查的临床分析

目的 探讨吸烟对检查对象肺功能的影响,总结其规律性,寻求可能的干预方法.方法 选择2010年1～12月到笔者所在医院体检的研究对象共255例.吸烟组135例,非吸烟组120例.按常规检查肺功能,检查第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC、最大呼气中期流速（MMEF）、75%、50%、25%肺活量位的最大呼气流速（MEF75、MEF50、MEF25）、呼气峰流速（PEF）.结果 反映肺功能的指标FEV1、FEV1/FVC、MMEF、PEF、MEF50等在吸烟组明显下降,两组比较第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC、最大呼气中期流速（MMEF）、75%、50%、25%肺活量位的最大呼气流速（MEF75、MEF50、MEF25）、呼气峰流速（PEF）,差异均有统计学意义（P〈0.05）.结论 吸烟者在尚无临床症状时,其肺通气功能已明显下降,肺功能的变化受吸烟影响,较长期大量吸烟的人的肺功能的减退尤为明显.     

道路空气污染对交通警察肺功能的影响

目的观察汽车尾气空气污染对健康成年男性肺功能的慢性长期影响。方法测定北京市区5环之内工作的100名交通警察及34名健康人的肺功能情况，指标包括：峰流速值（PEF）、用力呼气肺活量（FVC）、第1秒用力呼气容最（FEV，）及弥散量（TLCOc／SB）。按工作区域分为4组：2环路组、3环路组、4环路组、5环路组，按岗龄分为3组：1—10年岗龄组、11—20年组、21年以上组；观察各组间的指标并与止常对照组进行比较。结果21年以上岗龄组各指标均明显低于正常对照组和11—20年组，差异有统计学意义（P〈0．05）；2环路组各指标均低于5环路组，其中FVC的差异有统计学意义（P〈0．05）：与正常对照组比较，2环路组、3环路组、4环路组的PEF和2环路组的TLCOc／SB均明显降低，差异有统计学意义（P〈0．05）；非吸烟警察组的PEF明显低于正常对照组且有统计学意义（P〈0．05）；年龄、岗龄及吸烟指数与各指标间均呈负相关，其中年龄与FVC、岗龄与FVC、FEV1、TLCOc／SB间的相关性均有统计学意义（P〈0．05）。结论长期接触汽车尾气等空气污染物小仅造成肺通气功能下降，也能造成肺弥散功能的下降。     

某煤矿掘砌工人肺通气功能分析

[目的]了解煤矿掘砌工人肺通气功能损伤情况,探讨接尘工龄对肺功能的影响。[方法]。选取某煤矿纯掘砌工（纯掘砌作业工人）221名作为接尘组,选取该矿83名非接尘工人作为对照。行统一的体检和肺功能测定。测定结果均采用相对值,运用卡方检验、协方差分析进行统计学处理。[结果]接尘组非吸烟工人肺通气功能异常率与对照组差异不具有统计学意义（P〉0．05）,而接尘组吸烟工人肺通气功能异常率高于对照组（P〈0．05）。Mantel—Haenszel妒分析显示接尘组肺通气功能异常率高与对照组（P〈0．05）。以吸烟作为协变量,协方差分析结果显示,接尘组的用力肺活量、第一秒用力呼出量、呼气高峰流量、用力肺活量最大值、第一秒用力呼出量最大值明显低于对照组（尸〈0．05）。以吸烟为协变量,协方差分析结果显示,接尘组30年一工龄组呼气高峰流量和25％肺活量最大呼气流量明显低于10年～工龄组和20年～工龄组。以吸烟为分层因素,接尘组与对照组以及接尘组不同工龄间慢性阻塞性肺疾患患者分布差异均无统计学意义（P〉0．05）。[结论]掘砌作业工人肺通气功能明显低于对照组并随接尘工龄延长而降低。肺通气功能检测可以作为监测接尘作业工人肺部损失的指标。     

煤工尘肺患者646例肺通气功能分析

目的探讨煤工尘肺患者肺通气功能的损害情况。方法对646例男性煤工尘肺患者和320例男性接尘工人进行肺通气功能测量并比较。结果各期煤工尘肺患者的肺活量（VC）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1.0）、FEV1.0、FVC百分比、25％呼气中期流速（MEF75％）、50％呼气中期流速（MEF50%）、75％呼气中期流速（MEF25%）、最大呼吸中期流速（MMEF）、最大通气量（MVV）均明显低于对照组，差异有统计学意义（P〈0．01），Ⅰ、Ⅱ、Ⅲ期煤工尘肺患者肺通气功能异常率分别为77．78％、88．54％和100．00％，明显高于对照组，差异有统计学意义（P〈0．01）；Ⅰ、Ⅱ期煤工尘肺患者肺通气功能损害类型主要为阻塞性和混合性，Ⅲ期煤工尘肺患者肺功能损害以混合性为主。结论各期煤工尘肺患者的肺通气功能损伤明显，尘肺患者肺通气功能随尘肺期别增加而降低。     

尘肺患者肺通气功能分析

目的观察尘肺患者肺通气功能的损害情况。方法对200例尘肺患者、100例0^＋者和80例X线胸片正常的接尘工人进行肺通气功能测试。结果0^＋及Ⅰ、Ⅱ期患者的用力肺活量（FVC）、第1秒用力呼气量（FEV1.0）、FEV1．0／FVC％、最大通气量（MVV）、25％-75％用力呼气中期流速（FEF25%-75%）均低于对照组，Ⅱ期患者的FVC、FEV1.0、FEV1.0／FVC％、MVV、FEF25%-75%显低于Ⅰ期及0^＋，差异均有统计学意义（P〈0.01）；Ⅰ、Ⅱ期尘肺肺功能损害均以混合性通气功能障碍为主，发生率分别77．6％和90．5％。与〈60岁组比较，60岁以上尘肺患者各项肺功能指标均下降，差异有统计学意义（P〈0．01）。结论尘肺患者肺功能损害以混合性通气功能障碍为主，无尘肺的0^＋者有肺功能损害。     

我国北方职业人群肺通气功能指标预计值及其影响因素

目的 为开展职业人群肺通气功能测定提供依据.方法 以人员比较稳定的5所大、中型企业的在岗及退休职工中劳动强度以中度、轻度为主的人员共5 002人为受检者;采用日本Chest公司HI-198肺功能仪,按照美国胸科协会（ATS）对肺功能测定和评价的建议,进行肺通气功能测试,3913人的测试结果用于建立预计值回归方程.结果 正态性检验和频率分布曲线分析显示,所获数据符合或基本符合正态分布.单因素相关分析表明,年龄、身高分别与用力肺活量（FVC）、一秒用力呼气量（FEVi）、一秒用力呼气量/用力肺活量百分比[FEV1/FVC（%）]和最大呼气中期流速（MMF）的相关性有统计学意义（P＜0.05）.单因素相关分析及多元逐步回归分析显示,FVC、FEV1、FEVi/FVC（%）、MMF受年龄、身高、体重影响较大,而受胸围变量（呼气胸围、吸气胸围、呼气胸围与吸气胸围之差）影响较小.综合分析仅将年龄、身高、体重3个变量引入预计值回归方程,经与引入多个变量的回归方程比较,差异无统计学意义（P＞0.05）.所获预计值回归方程经原始资料、考核资料回代检验,符合率均大于90%,且原始资料与考核资料的肺通气功能指标,差异无统计学意义（P＞0.05）.结论 提出了适用于我国北方职业人群肺通气功能评价的非吸烟健康男性和女性、吸烟健康男性的FVC、FEVi、FEV1/FVC（%）、MMF肺通气功能指标的预计值公式建议.     

煤矿接尘工人高血压病对肺功能的影响

对患有高血压的222名煤矿接尘工人(高血压组,未经药物治疗)及同地区同工种218名血压正常者(对照组)进行肺功能测定。结果显示,高血压组吸烟者和不吸烟者分别与相应的对照组比较,反映大气道功能的指标用力肺活量(FVC)、第1秒时间肺活量(FEV1.0)和用力呼气1秒率(FEV1.0/FVC)差异均无统计学意义(P>0.05)。反映小气道的指标25%FVC时的用力呼气流量(FEF75)和最大呼气中期流速(MMEF75/25)高血压组吸烟者低于对照组不吸烟者(P<0.05);高血压组不吸烟者MMEF75/25低于对照组不吸烟者(P<0.05);对照组吸烟者FEF75、MMFF75/25低于对照组不吸烟者(P<0.05);根据1999年WHO/ISH高血压治疗指南,将高血压组吸烟者按血压水平分为3组,高血压3级组吸烟者FEF50低于高血压1级组吸烟者(P<0.05)。说明高血压随着病情的进展对肺功能产生一定的影响,尤其对小气道影响较明显。高血压病和吸烟对小气道影响有相加作用,控制吸烟及高血压病的发生和进展对改善煤矿接尘工人的肺功能是有益的。     

青年轻度吸烟者小气道功能测定

为了解青年人吸烟对小气道功能的影响，我们随意选择了青年吸烟者和非吸烟者各州）例，测定外分析厂肺活量、用力肺活量及呼吸中期流速和小气道一些功能检查，观察比较了两组对肺通气功能的影响。、对象与方法！分组际准非吸烟组为：①无吸烟史；②无慢性心肺疾病史，胸片正常；③查体无胸廓畸形，心肺无异常；①险查前1周元上呼吸道感染史。轻度吸烟组标准为：平均吸烟指数卜D日吸烟数）吸烟年数）为66，除厂非吸烟组际准中第①项外，其他们同。两组受测者均为男性，平均年龄ZO～25岁，吸烟者平均吸烟指数为轻度吸烟，两组受测者平均年龄…     

陶瓷企业接尘工人肺功能研究

目的 探讨陶瓷粉尘作业工人肺功能损伤的特征。 方法 采用美能(日本) AS507型肺功能仪,测定某陶瓷厂"无尘肺"的967名接尘工人(接尘组)和197名非接尘健康工人(对照组)的肺通气功能。 结果 陶瓷粉尘总尘浓度为0.10~2.95 mg/m3,总尘浓度超标率为14.29%,呼吸性粉尘浓度超标率为3.57%;粉尘中游离SiO₂含量为21.3%~43.0%。接尘组VC、FVC、FEV 1、FEV 1%、FEF 25%和FEF 50%的数值均低于对照组,差异有统计学意义(P<0.05或P<0.01)。接尘组肺通气功能损伤和小气道损伤的发生率均高于对照组,差异有统计学意义(P<0.05)。接尘的吸烟者VC、FEV1和FEV1%数值与非吸烟者相比,差异有统计学意义(P<0.01)。接尘工人肺通气功能损伤发生率为7.45%(72/967),其中轻度损伤者占98.61%(71/72),限制性肺通气功能损伤占97.22%(70/72)。 结论 陶瓷粉尘可引起接尘工人肺功能的损伤,其损伤程度以轻度为多,损伤类型以限制型损伤为主。肺功能损伤主要与粉尘、接尘工龄、工种和吸烟等因素有关。     

Interactive effect of paraoxonase-1 Q192R polymorphism and smoking history on the lung function decline in grain workers

PURPOSE: This retrospective longitudinal study investigated the association between the Q192R polymorphism of the high-density lipoprotein-associated multifunctional antioxidant enzyme, paraoxonase-1 (PON1), and lung function decline, while taking into account smoking history. METHODS: The demographic, occupational, and respiratory symptom information and lung function variables were obtained from 216 male Saskatchewan grain workers. RESULTS: An interaction between the PON1 genotypes and smoking status was observed. Current smokers with the 192R allele had a lower forced expiratory volume in the first second (FEV(1)) and FEV(1) per forced vital capacity (FVC). The annual decline rate of FEV(1)/FVC in current smokers was greater among 192R allele carriers than noncarriers (0.58+/-0.05 vs. 0.35+/-0.04 %/yr, p<0.0001). A similar result was observed with FEV(1) (40.9+/-6.4 vs. -33.0+/-7.0 mL/yr, p=0.10). The annual decline rate of FVC was not influenced by the genotypes. CONCLUSIONS: These results strengthened the previous findings of our cross-sectional study, suggesting that the 192R allele may be a novel genetic risk factor for airway injury among current smokers.     

Functional and high-resolution computed tomographic studies of divers' lungs

OBJECTIVES: Several cross-sectional studies have described a decrease in the expiratory flow rates of divers. The objective of this study was to determine whether the combined application of high-resolution computed tomography (HRCT) and lung function testing supports the reported development of small airway obstruction in divers. METHODS: Thirty-two navy divers, 27 commercial divers, and 48 referents matched for age and smoking history underwent pulmonary function testing and HRCT of the lungs supplemented by a limited number of expiratory scans. The commercial divers were older and dived longer than the navy divers. Multivariate regression analysis was used to assess the relevant correlations of age, height, pack-years of cigarette smoking, and indices of diving exposure with lung function parameters. RESULTS: The inspiratory vital capacity and forced vital capacity (FVC) were greater, while the FEV% [(100 x FEV10)FVC] and maximum expiratory flow (MEF) at 25% (MEF25) of the FVC were lower for the navy divers than for the referents. The lung volumes and expiratory airflow pattern did not differ between the commercial divers and the corresponding referents. The forced expiratory volume in 1 second (FEV10), FEV%, MEF75, and MEF25 correlated negatively with the years of diving experience. This association was independent of age, height, and pack-years of cigarette smoking. For the majority of the divers and referents the expiratory HRCT revealed minor lobular air trapping without any difference between the groups. The HRCT did not show relevant morphologic abnormalities of small or large airways. CONCLUSIONS: The data confirm that diving may affect pulmonary function. However, there is no radiologic evidence for the development of small airway disease in these 2 subgroups of divers.     

Pulmonary function in relation to cigarette smoking and smoking cessation. MRFIT Research Group.

BACKGROUND. More than half of the subjects in the MRFIT smoked at baseline and 10% of the subjects stopped smoking permanently during the first year of the trial. In this report, rates of decline in forced expiratory volume in 1 sec (FEV1) are compared for early permanent quitters and smokers who continued to smoke throughout the trial. METHODS. Since pulmonary function testing was not standardized across all centers until the third annual visit cycle, change in FEV1 is examined over the latter half of the trial; the level of FEV1 is analyzed cross-sectionally at the midpoint of the trial. Analyses are limited to 4,926 subjects who never used beta-blockers or smoked cigars, cigarillos, or pipes during the trial and who had annual FEV1s measured over 2-4 years in the latter half of the trial. RESULTS. Quitters during the first 12 months experienced smaller declines in FEV1 over the latter half of the trial than continuing smokers, with -50.7 ml/year versus -59.0 ml/year, respectively, adjusted for the level of FEV1 (P = 0.05). Cross-sectionally, those who had never smoked, former smokers, quitters, and continuing smokers showed a gradient of decreasing FEV1, and all four smoking groups were significantly different from each other (P less than 0.05). CONCLUSIONS. These data suggest that if a middle-aged, healthy smoker stopped smoking permanently, he could expect his FEV1 to deteriorate at a more gradual rate 3-4 years after stopping smoking than a similar smoker who continued to smoke. No information was available for the complete MRFIT cohort on the pulmonary function effects immediately following smoking cessation.     

Pulmonary function in long-term asbestos workers in China

The relationship of pulmonary function to exposure to asbestos and radiographic abnormalities has been controversial, especially when smoking is present as a confounder. The aim of the study was to provide further understanding on the radiographic-physiologic associations in nonsmoking and smoking asbestos workers. Radiographic asbestosis, pleural lesion, and pulmonary function were studied in 269 Chinese asbestos workers, with average exposure years of 23 for male workers and 18 for female workers. Their functional data were compared with those of 274 controls without exposure to dust. Although most of the male workers were smokers, none of the female workers smoked. In comparison with controls, asbestos workers had significantly lower lung volume and diffusing capacity, irrespective of gender. Female workers and smoking male workers had lower measurements of forced expiratory volume in 1 second and instantaneous forced expiratory flow at 50% and 25% of forced vital capacity. After adjustment for relevant covariates, asbestos exposure, asbestosis, and pleural abnormalities were associated with decreased parameters of pulmonary function, including lung volume, diffusing capacity, and airway flow. These data indicate that asbestos-related functional defects manifested by lung restriction and mild airway obstruction correlate with exposure to asbestos and with parenchymal and pleural abnormalities, independent of smoking.     

分析CT影像结合肺功能检测评估慢性阻塞性肺疾病的临床价值

目的：分析慢性阻塞性肺疾病（COPD）实施CT影像结合肺功能检测的评估意义。方法：选取2018年2月～2020年10月本院收治的38例COPD患者纳入观察组,同期38例无慢性咳嗽病史患者纳入对照组。对比CT影像学表现、肺功能结果。结果：中重度组FEV1、FEV1/FVC指标与对照组相比差异有意义（P<0.05）,轻度组的FEV1/FVC与对照组差异有意义（P<0.05）。CT检查中度组LAA≥2级肺气肿,无管壁增厚或少数1级增厚;重度组LAA≥2级肺气肿,≥1级增厚。结论：CT影像结合肺功能检测能够准确诊断COPD疾病,明确患者病情严重程度。     

慢性咳嗽患者小气道功能的改变及其临床价值

目的 初步评价肺功能检测中反映小气道功能的指标对慢性咳嗽患者鉴别诊断的临床价值.方法 对109例慢性咳嗽患者进行常规肺功能检测和支气管激发试验,观察支气管激发试验阳性患者与阴性患者小气道功能指标的差异,以及小气道功能异常与正常患者肺功能指标差异和支气管激发试验的阳性率.结果 109例患者中支气管激发试验阳性60例,阴性49例.支气管激发试验阳性患者峰值呼气流速、最大呼气中期流速75/25、呼气中段流速(FEF)25、FEF50、FEF75较阴性患者低,差异有统计学意义(P<0.05),肺活量、用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积占用力肺活量百分比两者比较差异无统计学意义.109例患者中有48例提示小气道功能异常,其中39例支气管激发试验阳性,占81.2%;而小气道功能正常的6l例患者中,有21例支气管激发试验阳性,占34.4%,两者阳性率比较差异有统计学意义(P<0.01).结论 肺功能中反映小气道功能的指标能预测气道高反应性,对于大量不能开展支气管激发试验的基层医院,有助于发现早期咳嗽变异型哮喘患者,尤其对于合并小气道病变的年轻患者更重要.     

Abnormal pulmonary function associated with diaphragmatic pleural plaques due to exposure to asbestos

Pulmonary function was measured in 79 men with diaphragmatic pleural plaques (DPP) as the only abnormality characteristic of asbestos disease on chest radiographs. They were selected from 4572 construction and shipyard workers exposed to asbestos. Abnormalities of pulmonary function in 21 non-smokers and 43 current smokers were compared with referent values adjusted for height, age, and duration of cigarette smoking. In the non-smokers, flows (FEV1) FEF75-85 and FEV1/FVC) were reduced and TGV and RV/TGV were raised. Current smokers had similar significant reductions. Thus by contrast with some current opinion that plaques are "an index only of past asbestos exposure," workers with plaques, even limited to the diaphragm, have functional impairment typical of pulmonary asbestosis. This suggests that they have pulmonary asbestosis, which is below the threshold of radiographic recognition.     

Abnormal pulmonary function associated with diaphragmatic pleural plaques due to exposure to asbestos.

Pulmonary function was measured in 79 men with diaphragmatic pleural plaques (DPP) as the only abnormality characteristic of asbestos disease on chest radiographs. They were selected from 4572 construction and shipyard workers exposed to asbestos. Abnormalities of pulmonary function in 21 non-smokers and 43 current smokers were compared with referent values adjusted for height, age, and duration of cigarette smoking. In the non-smokers, flows (FEV1) FEF75-85 and FEV1/FVC) were reduced and TGV and RV/TGV were raised. Current smokers had similar significant reductions. Thus by contrast with some current opinion that plaques are "an index only of past asbestos exposure," workers with plaques, even limited to the diaphragm, have functional impairment typical of pulmonary asbestosis. This suggests that they have pulmonary asbestosis, which is below the threshold of radiographic recognition.