戒烟对吸烟哮喘患者肺功能和哮喘控制的影响

目的旨在探讨戒烟对吸烟哮喘患者肺功能和哮喘控制的影响。方法将78例吸烟哮喘患者采用连续入组的方式:30例继续吸烟(吸烟组)和48例自愿戒烟。自愿戒烟者采用药物辅助戒烟2周,其中22名吸烟哮喘患者成功戒烟(戒烟组)。所有患者均给予丙酸氟替卡松250μg,每次1吸,每日2次,持续使用3个月。所有患者随访3次,每月1次,每次检测通气功能第1秒用力呼气量(FEV1)和用力肺活量(FVC)]和哮喘控制测试(ACT)评分。患者记录哮喘日记,内容包括日间症状评分、夜间症状评分、沙丁胺醇气雾剂用量。结果戒烟组FEV1和FVC改善率较吸烟组增加(15.22±2.34)%vs(6.42±3.15)%,(16.63±3.25)vs(3.82±1.24)%)],差异均有统计学意义(t分别=22.86、22.58,P均<0.05)。第1、2、3月吸烟组和戒烟组达到部分控制患者分别为(21/21 vs 3/28)、(21/21 vs 7/28)、(16/21 vs 5/28)],第3月达到完全控制为(5/21 vs 2/28),两组比较,差异均有统计学意义(χ2分别=25.36、32.78、26.36、16.36,P均<0.05)。结论戒烟可以明显改善吸烟哮喘患者肺功能,提高哮喘控制水平,提示戒烟在哮喘管理中起到重要作用。

Effect of smoking cessation on lung function and asthma control in smoked asthmatic patients

Objective To investigate the effect of smoking cessation on lung function and asthma control in smoked asth- matic patients. Methods Seventy-eight smoked asthmatic patients were recruited. By education, 30 patients continued to smoke （smoking group）, and 48 patients voluntarily gave up smoking. At the aid of drugs, 22 patients quit smoking successfully（smoking concession group）.All patients were treated with 250 ug fluticasone propionate twice a day for 3 months. The lung function, including forced expiratory volume in 1st second（FEV1 ）, forced vital capacity（FVC）, and score of asthma control test （ACT） was measured once a month. Asthma diary, such as scores of day and night symptom and dosage of salbutamol was recorded. Results The change of FEV1 and FVC was significantly increased in smoking concession group compared with that in the smoking group（15.22±2.34）% vs （6.42±3.15）%, t=22.86;（16.63＋3.25） vs （3.82±1.24）%, t= 22.58].Patients obtaining partial control in two groups were（21/21 vs 3/28, χ2=825.36,P〈0.05） at the first month（21/21 vs 7/28, χ2=32.78,P〈0.05） at the second month and（16/21 vs 5128,X2=26.36,P〈0.05） at the third month,respectively, obtaining complete control were （5/21 vs 2/28,χ2=16.36, P〈0.05） at the third month. Conclusions Smoking concession could improve lung function and asthma control level, suggesting that smoking cessation play a key role in management with smoked asthmatic patients.