一氧化碳污染与哮喘成人肺功能下降有关
2010/08/20
关键词：空气污染；哮喘；一氧化碳；肺功能；呼气峰流速
为了研究空气污染对肺功能的影响，Canoval等对19位居住在意大利Padua市哮喘患者进行了为期2年的观测性研究，每个病人进行5期观测，每期30天，共观测了1492个清晨和1434个晚间。研究中，以便携式电子肺功能仪测定PEF和FEV1，并于室外城市监测点采集每日空气污染水平和气象学资料。
无论清晨PEF或晚间PEF均与大气一氧化碳（CO）水平之间存在明显的负相关(p = 0.01–0.03)。一氧化碳每增加1mg·m–3，PEF下降2.6– 2.8%。CO对PEF的影响非常明显，甚至在明显控制吸入性颗粒(PM10)、NO2或SO2水平后，这一作用更为明显。CO对FEV1似乎也有相似的作用趋势，但二者之间的关系没有统计学意义。另外研究还发现，PEF和SO2之间也存在没有统计学意义的负相关。但PEF或FEV1与PM10 或NO2 浓度均不存在相关性。
根据以上研究结果，作者认为，成人哮喘的肺功能恶化与大气污染有关，而且这一现象发生在CO和SO2低于欧洲现行标准的情况下，因此应积极控制环境污染，改善大气条件。
（韩伟 青岛大学附属青岛市立医院东院 266071 摘译）
（Eur Respir J 2010; 35:266-272）
Carbon monoxide pollution is associated with decreased lung function in asthmatic adults
C. Canova1, S. Torresan1, L. Simonato1, et al. Dept of Environmental Medicine and Public Health, University of Padua, Padua, Italy.
Keywords: Air pollution, asthma, carbon monoxide, lung function, peak expiratory flow
The aim of the present study was to test the effects of exposure to air pollutants on lung function.
A panel of 19 adult asthmatics living in Padua (Italy) was followed for five 30-day periods during 2 yrs consecutively (1,492 morning and 1,434 evening measures analysed). Peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) were measured using a pocket electronic meter. Daily levels of air pollutants and meteorological variables were collected at outdoor city monitoring sites.
Significant inverse associations were observed between morning and evening PEF and carbon monoxide level (p = 0.01–0.03), without clear differences between lags (0–3 days). An increment of 1 mg·m–3 CO was associated with a PEF variation ranging -2.6– -2.8%. All effect estimates on PEF for CO remained significant and even increased after controlling for particles with a 50% cut-off aerodynamic diameter of 10 µm (PM10), nitrogen dioxide and sulphur dioxide in single and multi-pollutant models. A similar trend was observed for FEV1, but the associations were nonsignificant. A nonsignificant inverse relationship between evening PEF and SO2 was also detected. PEF and FEV1 were not related to PM10 and NO2 concentrations.
The present results indicate that, in this panel of adult asthmatics, the worsening of lung function is associated with exposure to gaseous pollutants and occurs at levels of CO and SO2 lower than current European standards.
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