辽宁省六城市4168例老年吸烟者流行病学调查及肺功能检测情况

目的 了解老年人吸烟的流行病学状况及吸烟后对肺功能的影响.方法 对辽宁省六城市部分社区的60岁以上老年人采用统一问卷调查及体检,总结相关的流行病学特征,并经筛选和剔除后,对4168例吸烟者及3598例非吸烟者进行肺功能测定.结果 60岁以上老年人吸烟者占到同年龄人群的30.89％.吸烟者的肺功能指标低于非吸烟者:肺容积指标残气量(RV)/肺总量(TCL)比较,有显著性差异(P＜0.05)；肺通气功能指标一秒钟用力呼气容积( FEV1)、FEV1用力肺活量(FVC)％比较,有显著性差异(P＜0.05)；反映小气道功能的指标MMEF比较有显著性差异(P＜0.001),而且其降低程度与年龄呈正相关.结论 吸烟对老年人肺功能的损伤不容忽视,应尽早戒烟,保护老年人的肺功能.     

523例老年人肺功能测定分析

本文对５２３例６０岁以上老年人进行了肺功能测定，其中健康组１０９例，健康吸烟组１０９例，慢性支气管炎组６７例，肺气肿组１９６例，肺心病组４１例。结果显示，健康老年人的肺功能随年龄增加而减低，长期吸烟不仅损害肺通气功能，亦损害小气道功能。而慢支和肺气肿患者随肺气肿程度的加重肺功能损害愈明显。故对ＣＯＰＤ患者应定期测定肺功能，了解肺功能损害程度，采取措施，积极预防。     

吸烟对肺结核病人肺功能的影响

吸烟对肺结核病人肺功能的影响浙江省杭州市结核病防治院３１００１４王立新吸烟对健康人呼吸道损害是众所周知的，对肺结核病人的肺组织损害及治疗效果的影响也屡见报道，但吸烟对肺结核病人呼吸生理的影响不多。本文对肺结核病人中６０例吸烟者和４３例不吸烟者的肺功能...     

肺年龄在评估肺功能损害中的作用探讨

众多的致病因素中 ,香烟烟雾是引起COPD最重要的危险因素。笔者在实践中发现除了应用肺量计测定FEV1来表明吸烟者通气功能的损害———即将受试者FEV1 测定结果与预计参考值比较外 ,还可用“肺年龄”(lungage)来表明吸烟的危害。所谓肺年龄是指与患者肺功能测定结果(FEV1 )相对应的正常受试者的年龄 ,如果一个受试者肺年龄老于实际年龄的程度越严重 ,即其对外界有害因素更易感。可利用线性回归方程推算出每一位患者的肺年龄 ,再将肺年龄与受试者实际年龄相比较 ,用以评价吸烟对肺的损害程度 ,这样对于劝告患者尽早戒烟 ,效果较好 ,现…     

脉冲振荡技术在支气管哮喘治疗效果评价中的临床应用

目的探讨脉冲振荡(IOS)技术对哮喘患儿治疗效果的评价作用。方法采用德国JAEGER公司生产肺功能仪对30例哮喘急性发作期患儿前后分别进行IOS和常规肺通气功能检查,哮喘患儿按照2008年哮喘指南给予正规治疗达到临床缓解后,再次测试30例哮喘患儿的IOS和常规通气功能检查,对比IOS和常规肺通气功能检查的结果并进行相关性分析。结果哮喘患儿临床缓解期的常规肺通气功能指标:FEV1、FEF50、FEF75、MMEF75/25较急性发作期的肺功能指标明显好转,差异具有统计学意义(P0.05),并且IOS指标Z5、R5、X5、Rp较急性发作期的肺功能指标明显降低,差异具有统计学意义(P0.05);进行相关性分析显示:Z5、R5与FEV1成负相关,X5与FEF25、FEF50成正相关。结论 IOS可以用于儿童哮喘治疗效果监测,是一种简便、需要配合程度低、无创的方法,值得在哮喘管理中推广应用。     

健康老人吸烟与非吸烟者通气功能的比较

健康老人吸烟与非吸烟者通气功能的比较江苏省钟山干部疗养院（２１００１４）谢静秋为了观察吸烟对肺功能损伤的性质和程度，兹就我院１９８９～１９９２年期间６０岁以上基本健康老人肺功能检查（包括小气道功能在内）资料进行分析，将其中吸烟者与不吸烟者（对照组）的...     

吸烟对COPD患者肺功能的影响

目的探讨吸烟与慢性阻塞性肺疾病（COPD）病因及肺功能受损严重程度间的关系。方法对我院住院的1013名有肺功能测定记录中肺功能异常的134例缓解期COPD患者进行研究,调查吸烟与COPD患者肺功能的关系。按2002年中华呼吸学会制定的标准进行COPD诊断与严重程度分级。结果肺功能异常134例中、轻度异常49例（36.6%）,中度44例（32.8%）,重度41例（30.6%）。在肺功能轻度异常的患者中,不吸烟人数为20人（40.8%）,吸烟人数为29人（59.2%）。在肺功能中度异常患者中,不吸烟人数为7人（17.1%）,吸烟人数为34人（82.9%）。表明吸烟者较不吸烟者肺功能更差,吸烟者较不吸烟者FEV1/FVC更低,RV%增加,TLC增加。结论吸烟与COPD发病有着密切的关系,吸烟人群中重度COPD发病人数明显增多。因此对于COPD患者应该加强戒烟教育。     

脉冲振荡技术对慢性阻塞性肺疾病患者肺功能的诊断价值评价

目的 评价脉冲振荡法（IOS）在慢性阻塞性肺疾病（COPD）肺功能诊断中的价值。方法 随机对296例COPD缓解期患者（COPD组）和171例健康者（对照组）进行包括脉冲振荡法（IOS）及常规肺通气在内的肺功能测定，比较两组IOS测试结果，评价IOS与常规肺通气检测的一致性。结果 与对照组比较，COPD组IOS测试值比较差异有显著性（P〈0．05），且差异呈频率依赖性。Fres、R5-R20、R5、X5等IOS值同FEV1％、FEV1／FVC、PEF、FEF50等有显著相关性（P〈0．05）。结论 脉冲振荡法与常规通气试验具有较好的一致性，可以反映早期气道阻塞情况。     

脉冲振荡法测定支气管哮喘患者呼吸阻抗的临床意义

目的探讨呼吸阻抗对支气管哮喘的诊断价值。方法185例健康人和192例支气管哮喘患者进行脉冲振荡肺功能（IOS）测定，并与常规肺通气功能比较。结果支气管哮喘患者与健康人相比，Zrs、Re、Rp、Fres、R均显著增高，X明显降低。支气管哮喘患者Zrs、Rp、Fres、R5、R5～R20与肺通气功能呈显著负相关，与Fres的相关性最为密切。结论IOS测定可用于支气管哮喘的诊断，Fres为诊断支气管哮喘气流阻塞最敏感的指标。     

脉冲震荡法测定矽肺患者肺功能的临床意义

目的探讨脉冲震荡法测定矽肺患者肺功能的临床意义。方法采用脉冲震荡（IOS）技术对我院2003年10月至2007年12月187例矽肺患者进行检测,与常规通气功能检测结果作比较。结果矽肺患者IOS三项指标的阳性率显著高于VC％,IOS总阳性率为89．3％,显著高于常规通气检测阳性率78．1％。结论矽肺患者IOS指标阳性率显著高于常规通气功能检查,IOS指标能提高矽肺早期检出率。     

重度吸烟者肺部振动反应成像动态图像特征初探

目的 探讨肺功能正常重度吸烟者的振动反应成像(vibration vesponse vmaging,VRI)动态图像特征.方法 观察60例健康非吸烟者(对照组)和67例肺功能正常的重度吸烟者(重度吸烟组)VRI图像.首先采集两组受试者的临床资料(病史、体格检查、胸部X线),然后进行肺功能测定和VRI检查,比较两组之间V...     

重度吸烟者肺部振动反应成像动态图像特征初探

目的探讨肺功能正常重度吸烟者的振动反应成像（vibration vesponse vmaging,VRI）动态图像特征。方法观察60例健康非吸烟者（对照组）和67例肺功能正常的重度吸烟者（重度吸烟组）VRI图像。首先采集两组受试者的临床资料（病史、体格检查、胸部X线）,然后进行肺功能测定和VRI检查,比较两组之间VRI动态图像特征的差异。结果重度吸烟组动态图像出现无序11例（16.4%）,跳跃43例（64.2%）,不同步11例（16.4%）,延迟6例（9.0%）,对照组动态图像无序4例（6.7%）,跳跃2例（3.3%）,不同步0例（0.0%）,延迟0例（0.0%）,这些征象在两组间的分布差异均有统计学意义。重度吸烟组的动态图像积分为1.22±0.42,明显高于健康非吸烟组0.13±0.01（P〈0.05）。结论肺功能正常的重度吸烟组的动态图像较对照组紊乱。     

Importance of smoking index for assessing lung damage by lung function tests

A total of 89 smokers of age varying between 15-52 years were assessed for lung function forced vital capacity (FVC), forced expiratory volume in one second (FEV1) ratio of FEV1 and FVC as FEV1% and peak expiratory flow rate (PEFR), before smoking (BS) and 30 min after smoking (AS). All the above lung function tests were reduced in smokers in comparison to those of age-matched non-smokers. Further, when observed test values of lung function were tabulated according to smoking index (SI), it was noted that reduction of lung function increased with SI.     

Cigarette smoking decreases interleukin-8 secretion by human alveolar macrophages

Cigarette smoking can impair pulmonary immune function, and hence influences the development of lung diseases. Interleukin-8 (IL-8) is a proinflammatory peptide and a potent chemotactic factor for neutrophils, and is produced by both immune and non-immune cells including monocytes and alveolar macrophages (AM). We investigated the effect of cigarette smoking on the secretion of IL-8 by human AM. The IL-8 concentration in bronchoalveolar lavage fluid (BALF) was much higher in smokers than in non-smokers (18.4 +/- 3.9 vs 4.1 +/- 1.0 pg ml-1; P < 0.005). However, spontaneous IL-8 secretion by cultured AM was lower in smokers than in non-smokers (46.8 +/- 12.7 vs 124.1 +/- 24.0 ng ml-1; P < 0.01). When stimulated with lipopolysaccharide (LPS), AM from smokers secreted significantly less IL-8 than those from non-smokers at all tested concentrations of LPS. In contrast, the amount of IL-8 secreted by peripheral blood monocytes with or without LPS stimulation was comparable in smokers and non-smokers. These observations indicate that smoking decreases IL-8 secretion by AM, which may modify or decrease the inflammatory response in the lung.     

Airway reactivity to inhaled mannitol in cigarette smokers: a longitudinal study

Smoking induces airway hyperresponsiveness (AHR). Bronchial provocation with mannitol is used to identify AHR in subjects with asthma. This study aimed to determine the prevalence of airway hyperresponsiveness to mannitol in asymptomatic smokers compared to non-smokers and to assess if airway responsiveness to mannitol changes after smoking cessation. Airway responsiveness to inhaled mannitol was measured in smokers (n=42), and non-smokers (n=45). In smokers, the mannitol test was repeated 3 months after smoking cessation. Demographics including age, lung function and atopy status were similar for smokers and non-smokers (p=ns). Compared with non-smokers (2.2%), AHR to mannitol expressed by 15%> or = fall in FEV(1) was significantly more common in smokers (26.2%) (p=0.001). The provoking dose to induce a 15%> or = fall in FEV(1) (PD(15)), a measure of sensitivity, was median [IQR] 291 mg [207-377] in the 11 positive smokers. The response-dose ratio (RDR) (% fall in FEV(1)/cumulative dose), a measure of reactivity, was significantly higher in smokers (0.013 [0.006-0.029]) compared with non-smokers (0.004 [0.002-0.007]), (p<0.0001). After successful smoking cessation, the RDR decreased in most cases (p=0.01) and only one patient still recorded a 15% fall in FEV(1). None of the patients with a negative mannitol test turned positive, irrespective of the outcome of smoking cessation. AHR to mannitol is quite common in smokers compared to non-smokers and decreases significantly after smoking cessation. Thus, the mannitol test may be sensitive to non-asthmatic inflammation of the airways.     

An electronic nose in the discrimination of breath from smokers and non-smokers: a model for toxin exposure

Exhaled breath contains hundreds of volatile organic compounds (VOCs) that may be used as non-invasive markers of lung disease. Electronic noses (e-noses) can analyse VOCs by composite nanosensor arrays with learning algorithms. This study investigated the use of an e-nose (Cyranose C320) to distinguish the breath of smokers from that of non-smokers. Smoking and non-smoking subjects exhaled from total lung capacity into a 2 L Tedlar bag and these samples were introduced offline to the e-nose in a random order. Two classes of breath, 'smoker' and 'non-smoker', were established and this model was then cross-validated. Principal component analysis then identified the maximal point of difference between classes. Smellprints of breath from smokers were separated from those of non-smokers (cross-validation value, 95%; Mahalanobis distance, 3.96). Subsequently, 15 smokers (mean age 37.9 ± 4.78 years, FEV(1) 3.15 ± 0.21 L), and 24 non-smokers (add mean age and FEV1 as for smokers) were sampled to revalidate the model. The e-nose correctly identified the smoking status in 37 of the 39 subjects. This demonstrates that the e-nose is simple to use in clinical practice and can differentiate the breath of smokers from that of non-smokers. It may prove to be a useful, non-invasive tool for further breath assessment of exposure to other inhaled noxious substances as well as disease monitoring.     

The effect of obesity and smoking status on lung age in Japanese men

Background and objective:   The lung age of smokers is greater than their real age. We have had the clinical impression that the lung age of non-smokers might be older than their real age and that obese subjects with decreased VC and FEV₁ would also have an increased lung age. This cross-sectional study investigated the relationships between lung age and smoking status, and lung age and BMI.
Methods:   Subjects comprised 3247 men who consulted our institute for health screening; 819 subjects were non-smokers. In smokers and non-smokers, lung age estimated by the predictive equation based on height and FEV₁ was compared with chronological age. To investigate the relationship between lung age and BMI in non-smokers, subjects were categorized into four groups based on quartiles of BMI and the lung age of the four groups compared. Multiple linear regression was used to determine the relative contribution of BMI and smoking status to lung age.
Results:   The predictive equation used to estimate lung age significantly overestimated the chronological age of study subjects. In non-smokers, higher BMI was significantly associated with higher lung age. BMI, duration of smoking and number of cigarettes per day were significantly associated with increased lung age.
Conclusions:   Lung age could be used to motivate lifestyle change in obese individuals.     

Identification of Occult Parechymal Disease Such as Emphysema or Airway Disease Using Screening Computed Tomography

ABSTRACT

Rationale: Chronic obstructive pulmonary disease (COPD) is a major public health problem. This study was performed to determine whether the low attenuation area (LAA) and visual score provided by low-dose computed tomography (CT) can be used to detect occult parenchymal disease, such as insidious COPD. Methods: Each participant underwent low-dose CT scan and pulmonary function tests. The LAA% of the corresponding lung area was calculated. The cut-off level between the normal lung density area and LAA was defined as –960 HU, and the severity of emphysematous change (visual score) and LAA% were evaluated on three same chest CT slices obtained at full inspiration. Results: Forty-eight of 2,247 individuals including 1058 non-smokers and 1189 smokers were diagnosed with COPD. Chest CT findings in individuals diagnosed with COPD showed centrilobular emphysema (50%), however, 17 of the subjects diagnosed with COPD had normal screening CT findings. Thirty-one subjects diagnosed with COPD showed a positive visual score, and 27 individuals with COPD showed LAA% of more than 30. Nine of 17 subjects with a negative visual score showed LAA% of more than 30. The visual score in smokers was significantly higher than that of non-smokers. The lung function in smokers was lower than that of non-smokers. Smokers also showed higher frequencies of chest CT abnormalities. Conclusion: Low-dose CT scans detected LAA and a positive visual score before COPD associated with an impaired lung function develops. Smokers with normal spirometry had a potential to develop an airflow obstruction accompanied with abnormal CT findings.     

Downregulation of lung mitochondrial prohibitin in COPD

Prohibitins (PHB1 and PHB2) are versatile proteins located at the inner mitochondrial membrane, maintaining normal mitochondrial function and morphology. They interact with the NADH dehydrogenase protein complex, which is essential for oxidoreductase activity within cells. However, their expression in lung epithelium, especially in smokers and patients with inflammatory lung diseases associated with increased oxidative stress, such as COPD, is unknown. Lung tissue specimens from 45 male subjects were studied: 20 COPD patients [age: 65.7?±?5.8 years, smoking: 84.6?±?33.6 pack-years, FEV(1) (%pred.): 58.7?±?14.6, FEV(1)/FVC (%): 63.8?±?9.4], 15 non-COPD smokers [age: 59.0?±?12.1 years, smoking: 52.5?±?20.8 pack-years, FEV(1) (%pred.): 85.5?±?14.2, FEV(1)/FVC (%): 78.5?±?4.7] and 10 non-smokers. Quantitative real-time PCR experiments were carried out for PHB1 and PHB2, using β-actin as internal control. Non-COPD smokers exhibited lower PHB1 mRNA levels when compared to non-smokers (0.55?±?0.06 vs. 0.90?±?0.06, P?=?0.043), while PHB1 expression was even further decreased in COPD patients (0.32?±?0.02), a statistically significant finding vs. both non-COPD smokers (P?=?0.040) and non-smokers (P?相似文献