短期暴露于高污染空气可增加中国北京市慢性阻塞性肺疾病患者气道炎症和呼吸道症状
2016/07/27
摘要
背景:很少有研究评估，在高污染的亚洲城市，短期暴露在高污染空气下对慢性阻塞性肺疾病（COPD）患者的影响。
方法：在中国北京，2014年1月到9月进行的两组研究期间，一组23例稳定期慢性阻塞性肺疾病患者反复进行气道炎症的生物标记物测量，包括呼出气一氧化氮（FeNO）和呼出气硫化氢（FeH2S）（215个测量结果），并记录日常的呼吸道症状（794人1天）。每天从附近的中心空气监测站获取环境空气污染数据。混合效应模型被用来评估暴露和健康数据之间的关联，这些健康测量指标进行了潜在混杂因素的调整，包括温度和相对湿度。
结果：空气污染物水平增加与呼出气一氧化氮（FeNO）和呼出气硫化氢（FeH2S）的显著增加有关。PM2.5（76.5μg/m3, 5天）、PM10（75.0μg/m3, 5天）和SO2 (45.7μg/m3, 6天)四分位数间距（IQR）增加与FeNO最大值增加有关，最大值增加分别为13.6%（95%可信区间：4.8%，23.2%），9.2%（95%可信区间：2.1%，16.8%）和34.2%（95%可信区间：17.3%，53.4%）。PM2.5（6天）、PM10（6天）和SO2 （7天）四分位数间距（IQR）增加与FeH2S的最大值增加相关，最大值增加分别为11.4%（95% CI：4.6%、18.6%）、7.8%（95%可信区间：2.3%，13.7%）和18.1%（95%可信区间：5.5%，32.2%）。空气污染物水平的增加与喉咙痛、咳嗽、痰、喘气和呼吸困难的比值比增加相关。
结论：呼出气硫化氢（FeH2S）可以作为一种新的生物标志物来检测空气污染对呼吸的不良影响。我们的研究结果对公共健康有潜在的重要性：在发展中国家人口密集城市高污染水平的背景下，周围环境空气污染可能会对呼吸系统的健康产生威胁。
（苏欣 审校）
Environ Int. 2016 May 19;94:76-82. doi: 10.1016/j.envint.2016.05.004. [Epub ahead of print]
Short-term exposure to high ambient air pollution increases airway inflammation and respiratory symptoms in chronic obstructive pulmonary disease patients in Beijing, China.
Wu S1, Ni Y1, Li H1, Pan L1, Yang D1, Baccarelli AA2, Deng F3, Chen Y4, Shima M5, Guo X1.
Author information
Abstract
BACKGROUND:Few studies have investigated the short-term respiratory effects of ambient air pollution in chronic obstructive pulmonary disease (COPD) patients in the context of high pollution levels in Asian cities.
METHODS:A panel of 23 stable COPD patients was repeatedly measured for biomarkers of airway inflammation including exhaled nitric oxide (FeNO) and exhaled hydrogen sulfide (FeH2S) (215 measurements) and recorded for daily respiratory symptoms (794person-days) in two study periods in Beijing, China in January-September 2014. Daily ambient air pollution data were obtained from nearby central air-monitoring stations. Mixed-effects models were used to estimate the associations between exposures and health measurements with adjustment for potential confounders including temperature and relative humidity.
RESULTS:Increasing levels of air pollutants were associated with significant increases in both FeNO and FeH2S. Interquartile range (IQR) increases in PM2.5 (76.5μg/m3, 5-day), PM10 (75.0μg/m3, 5-day) and SO2 (45.7μg/m3, 6-day) were associated with maximum increases in FeNO of 13.6% (95% CI: 4.8%, 23.2%), 9.2% (95% CI: 2.1%, 16.8%) and 34.2% (95% CI: 17.3%, 53.4%), respectively; and the same IQR increases in PM2.5 (6-day), PM10 (6-day) and SO2 (7-day) were associated with maximum increases in FeH2S of 11.4% (95% CI: 4.6%, 18.6%), 7.8% (95% CI: 2.3%, 13.7%) and 18.1% (95% CI: 5.5%, 32.2%), respectively. Increasing levels of air pollutants were also associated with increased odds ratios of sore throat, cough, sputum, wheeze and dyspnea.
CONCLUSIONS:FeH2S may serve as a novel biomarker to detect adverse respiratory effects of air pollution. Our results provide potential important public health implications that ambient air pollution may pose risk to respiratory health in the context of high pollution levels in densely-populated cities in the developing world.
Copyright © 2016 Elsevier Ltd. All rights reserved.
KEYWORDS:Air pollution; COPD; Exhaled airway markers; Respiratory symptom
Environ Int. 2016 May 19;94:76-82. doi: 10.1016/j.envint.2016.05.004. [Epub ahead of print]
