戒烟对稳定期慢性阻塞性肺疾病的治疗作用

目的探讨戒烟对稳定期COPD的治疗作用。方法纳入2011年7月-2013年7月经福建医科大学附属泉州第一医院肺功能室检查确诊的稳定期COPD患者193例，按是否采用戒烟治疗及最终完成情况分为戒烟成功组、戒烟失败组及非戒烟组：戒烟成功亚组62例，均为男性，平均年龄为（60．82±5．63）岁，平均吸烟指数为（852±100）年·支；戒烟失败亚组36例，均为男性，平均年龄为（60．61±4．91）岁，平均吸烟指数为（812±139）年·支；非戒烟组95例，均为男性，平均年龄为（60．49±8．77）岁，平均吸烟指数为（833土143）年·支。采用FEV。为肺功能评价指标，CAT评分为COPD病情评价指标。进行为期半年的随访。结果各试验组患者在年龄、体质量指数及吸烟指数等方面差异无统计学意义。戒烟成功组患者治疗后体质量增加（2．85±1．27）kg，CAT评分下降（6．05±2．60）分，戒烟前后对比差异有统计学意义（t值分别为17．763、18．351，P值均d0．01）；FEV，增加（O．04±0．18）L，戒烟前后对比差异无统计学意义（t=1．900，P=0．062）。而戒烟失败组及未戒烟组治疗前后体质量、CAT评分及FEV，变化差异均无统计学意义（P值均〉0．05）。结论戒烟半年即对稳定期COPD具有=定的治疗作用，主要表现在体质量增加、临床症状减轻，而肺功能则无明显改善。

Effect of smoking cessation in patients with stable chronic obstructive pulmonary disease

Objective To investigate the effect of smoking cessation in patients with stable chronic obstructive pulmonary disease （COPD）. Methods One hundred and ninety three adult patients with stable COPD treated by respiratory physicians in First Hospital of Quanzhou Affiliated to Fujian Medical University were included in a 6-month smoking cessation program. The patients were grouped as sustained quitter group,ex-quitter group,and continuing smoker group by smoking status：62 male patients were in the sustained quitter group, with average age of 60.82 ± 5.63 year and average smoking index of 852 ±100 year-cigarettes. Thirty six male patients were in the ex-quitter group, with average age of 60.61 ± 4.91 year and average smoking index of 812 ± 139 year-cigarettes. Ninety five male patients were in the continuing smoker group, with average age of 60.49 ±8.77 year and average smoking index of 833±143 year-cigarettes. Lung function was assessed with forced expiratory volume in one second （FEV1）. COPD health status was assessed using the COPD assessment test （CAT）. Results There was no significant difference in age,body mass index, and smoking index among the 3 groups. In sustained quitter group, weight of patients increased 2.85 ±1.27 kilograms and CAT scores decreased 6.05 ± 2.60 after the 6-month program. Matched t test showed that there was significant difference in patients＇ weight and CAT scores between pre-intervention and pos-intervention （ t = 17. 763,18. 351 respectively, P d0.01）. FEV1 increased 0. 044-0.18 liters, but matched t test showed no significant difference in FEV1 between preintervention and postSintervention （ t = t. 900, P = 0. 062）. In ex-quitter group and continuing smoker group, matched t test showed that there was no significant difference in patients＇ weight,CAT scores,and FEV1 between pre-intervention and post-intervention （ P〈0.05）. Conclusions Smoking cessation was an effective treatment for stable COPD. It increased the weight of patients and improved the