中国的大气污染和COPD  

Air Pollution and COPD in China

作　　者：胡国平[1] 钟南山[2] 冉丕鑫[2] 吴开杰(译)[3] 

机构地区：[1]广州中医药大学第三附属医院,广州510150 [2]广州医科大学第一附属医院,广州呼吸疾病研究所呼吸疾病重点实验室,广州510120 [3]西安交通大学第一附属医院泌尿外科

出　　处：《中国胸心血管外科临床杂志》2016年第2期107-112,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：中国“十五”发展计划中央政府重点科研项目(2001BA703B03(A));国家“十二五”发展计划国家关键技术的研发计划(2012BAI05B01)~~

摘　　要：最近,许多学者在关注大气污染和慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的关系。在过去的这个冬季里,一种严重的大气污染形式——雾霾正悄然影响着中国北部和东部的大部分地区。在中国,已有研究开始评估户外大气污染和生物燃料烟雾对COPD的影响,但多数研究在关注大气污染对疾病诱发和恶化的作用,几乎还没有研究关注大气污染在诱导具有COPD特征的病理生理学改变中的作用。有证据显示,户外大气污染影响儿童和成人的肺功能,且可诱导COPD症状的加重。因此,户外大气污染被认为是COPD死亡率的危险因素,现有证据也提示户外大气污染的慢性暴露可以增加COPD的发病率。横断面研究显示生物燃料烟雾暴露是COPD的危险因素,一项长期的回顾性研究和另一项前瞻性队列研究均显示减少生物燃料烟雾与第一秒用力呼气量(forced expiratory volume in 1 second,FEV_1)的改善及COPD危险性的降低相关。总之,为了更透彻地理解大气污染对COPD的影响,我们建议以后的研究要增加随访时间,提供更标准化的COPD定义和更精确的污染来源特异性评估。Recently, many researchers paid more attentions to the association between air pollution and chronic obstructive pulmonary disease （COPD）. Haze, a severe form of outdoor air pollution, affected most parts of northern and eastern China in the past winter. In China, studies have been performed to evaluate the impact of outdoor air pollution and biomass smoke exposure on COPD; and most studies have focused on the role of air pollution in acutely triggering symptoms and exacerbations. Few studies have examined the role of air pollution in inducing pathophysiological changes that characterise COPD. Evidence showed that outdoor air pollution affects lung function in both children and adults and triggers exacerbations of COPD symptoms. Hence outdoor air pollution may be considered a risk factor for COPD mortality. However, evidence to date has been suggestive （not conclusive） that chronic exposure to outdoor air pollution increases the prevalence and incidence of COPD. Cross-sectional studies showed biomass smoke exposure is a risk factor for COPD. A long-term retrospective study and a long-term prospective cohort study showed that biomass smoke exposure reductions were associated with a reduced decline in forced expiratory volume in 1 second （FEV1） and with a decreased risk of COPD. To fully understand the effect of air pollution on COPD, we recommend future studies with longer follow-up periods, more standardized definitions of COPD and more refined and source-specific exposure assessments.

关 键 词：生物燃料烟雾 大气污染 雾霾 慢性阻塞I生肺疾病(chronic OBSTRUCTIVE PULMONARY disease.COPD) 

分 类 号：R563.9[医药卫生—呼吸系统]