职业性哮喘患者FEV1的下降
2007/03/12
职业性哮喘患者持续暴露于工作场所的致敏因子与不良预后密切相关。然而，持续暴露于致敏因子时肺功能的下降速率以及脱离致敏环境对肺功能的影响则很少报道。Anees等应用直线回归分析法对156名职业性哮喘患者（87%为低分子量致敏因子所诱发）的 FEV1进行研究，旨在评估受试者脱离致敏环境前后FEV1的下降情况。结果发现，90名受试者在脱离致敏环境前FEV1下降速率均数为100.9ml/年，标准误为17.7ml；脱离致敏环境后1年，FEV1提高的均数为12.3ml ，标准误为31.6 ml。 86名受试者在脱离致敏环境后FEV1下降速率均数为26.6 ml/年，标准误为18.0ml。吸烟者与不吸烟者FEV1的下降程度无显著性差异,且FEV1的下降不受吸入性皮质类固醇的影响。因此作者认为，职业性哮喘患者暴露于致敏因子时FEV1快速下降,而当脱离致敏环境后,虽然其FEV1继续下降但下降速率减慢,且与健康成人的FEV1下降速率相似。
（戴元荣 温州,温州医学院附属第二医院呼吸内科 325027 摘译）
(Thorax.2006.61:751-755)
Author Anees, W; Moore, V C; Burge, P S
Institution Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham, UK
Title FEV1 decline in occupational asthma.[Miscellaneous Article]
Source Thorax. 61(9):751-755, September 2006.
Abstract
Background: In occupational asthma continued workplace exposure to the causative agent is associated with a poor prognosis. However, there is little information available on how rapidly lung function declines in those who continue to be exposed, nor how removal from exposure affects lung function.
Methods: Forced expiratory volume in 1 second (FEV1) was studied in 156 consecutive subjects with occupational asthma (87% due to low molecular weight agents) using simple regression analyses to provide estimates of the decline in FEV1 before and after removal from exposure.
Results: In 90 subjects in whom FEV1 measurements had been performed for at least 1 year before removal from exposure (median 2.9 years), the mean (SE) rate of decline in FEV1 was 100.9 (17.7) ml/year. One year after removal from exposure FEV1 had improved by a mean (SE) of 12.3 (31.6) ml. The mean (SE) decline in FEV1 was 26.6 (18.0) ml/year in 86 subjects in whom measurements were made for at least 1 year (median 2.6 years) following removal from exposure. The decline in FEV1 was not significantly worse in current smokers than in never smokers, nor was it affected by the use of inhaled corticosteroids.
Conclusion: FEV1 declines rapidly in exposed workers with occupational asthma. Following removal from exposure, FEV1 continued to decline but at a slower rate, similar to the rate of decline in healthy adults.
Methods: Forced expiratory volume in 1 second (FEV1) was studied in 156 consecutive subjects with occupational asthma (87% due to low molecular weight agents) using simple regression analyses to provide estimates of the decline in FEV1 before and after removal from exposure.
Results: In 90 subjects in whom FEV1 measurements had been performed for at least 1 year before removal from exposure (median 2.9 years), the mean (SE) rate of decline in FEV1 was 100.9 (17.7) ml/year. One year after removal from exposure FEV1 had improved by a mean (SE) of 12.3 (31.6) ml. The mean (SE) decline in FEV1 was 26.6 (18.0) ml/year in 86 subjects in whom measurements were made for at least 1 year (median 2.6 years) following removal from exposure. The decline in FEV1 was not significantly worse in current smokers than in never smokers, nor was it affected by the use of inhaled corticosteroids.
Conclusion: FEV1 declines rapidly in exposed workers with occupational asthma. Following removal from exposure, FEV1 continued to decline but at a slower rate, similar to the rate of decline in healthy adults.
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出生时肺功能下降与10年后出现哮喘之间关系的研究
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孟鲁司特和小剂量氨茶碱对哮喘患者心血管疾病危险因素的影响
