生物燃料烟雾暴露人群肺功能受损情况初步分析  

Preliminary analysis of lung function of population with biofuel smoke exposure

作　　者：赵东兴[1] 陈淑云[1] 周玉民[1] 李晓尘[1] 刘莎[1] 陈璐[1] 蒲金定 冉丕鑫[1] 

机构地区：[1]呼吸疾病国家重点实验室广州医科大学附属第一医院广州呼吸疾病研究所,510120

出　　处：《中华结核和呼吸杂志》2017年第5期349-353,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的分析生物燃料烟雾暴露者肺功能受损状况。 方法选取广东韶关农村地区常住人口，按自然村随机整群抽样调查，存在生物燃料烟雾暴露且不吸烟者为暴露组，以同地区无生物燃料烟雾暴露且不吸烟者为对照组。筛查纳入暴露组530名，其中男88名，女442名，年龄40～79岁，平均（54±10）岁；对照组187名，其中男46名，女141名，年龄40～80岁，平均（54±10）岁。两组间年龄、身高、体重、体重指数、腰围、臀围、腰臀围比值无明显差异（P〉0.05）。对两组人群进行问卷调查和肺功能检查，比较分析两组间肺功能的差异。 结果暴露组肺通气功能指标FEV1占预计值%和FEV1/FVC分别为（100±18）%和（80±10）%，均低于对照组[（106±25）%和（83±6）%，均P〈0.05]；小气道功能指标25%呼气流速（FEF25）、50%呼气流速（FEF50）、75%呼气流速（FEF75）、用力中期流速（MMEF）占预计值%也均明显低于对照组（P〈0.05）。单因素和多因素分析结果显示，生物燃料暴露指数与FEV/FVC的回归系数为－0.1，95%CI：－0.1～－0.1（P〈0.01）。对FEV/FVC和生物燃料暴露指数进行阈值分析，结果表明生物燃料暴露指数折点为46.0，折点处Y预测值为81.76 ，95%CI：80.2～83.33。生物燃料暴露指数〈46.0时回归系数Ⅰ为0，95%CI：－0.1～0.0（P〉0.05），生物燃料暴露指数〉46.0时回归系数Ⅱ为－0.1，95%CI：－0.2～－0.1（P〈0.01）。模型Ⅰ和Ⅱ对数似然比差异有统计学意义（P＝0.019）。 结论生物燃料烟雾暴露对肺功能有损伤作用。ObjectiveTo analyse the impaired lung functions of people with biofuel smoke exposure. MethodsNonsmokers with biofuel smoke exposure were selected as research objects in a mountainous area of northern Guangdong where the families used biofuels as main energies and the nonsmokers without biofuel smoke exposure in the same area as control. Questionnaire interviews and spirometry tests were performed on all subjects. To analyse the differences of lung functions in both. ResultsSeventy hundred and seventeen subjects were enro1led in this study.There were 530 nonsmokers with biofuel smoke exposure（observation group） including 442 women and 88 men, average age 54±10. There were 187 nonsmokers without biofuel smoke exposure（control group） including 141 women and 46 men, average age 54±10. There was no significant difference between two groups in age, height, weight, BMI, waist circumference, hip circumference and waist/hip ratio（P〉0.05）. The pulmonary ventilation function index（FEV1%Pred, FEV1/FVC） in the observation group was significantly less than that in control group [（100±18） vs.（106±25）; （80±10） vs.（83±6） respectively, P〈0.05]. Small airway function index（PEF25, PEF50, PEF75, MMPEF and MMPEF%Pred） was significantly less than that in control group（P〈0.01）. According to the univariate regression analysis and multivariate regression analysis, regression coefficients between BIOFUEL-INDEX and FEV/FVC was -0.1, 95%CI（-0.1, -0.1, P〈0.01）. According to the threshold analysis, the vertice of BIOFUEL-INDEX was 46.0, where the predicted Y value was 81.76, 95%CI （80.2, 83.33）. When BIOFUEL-INDEX〈46.0, the regression coefficient was 0, 95%CI （-0.1, 0.0）（P〉0.05）; when BIOFUEL-INDEX〉 46.0, the regression coefficient 2 was -0.1, 95%CI （-0.2, -0.1）（P〈0.01）. The difference between coefficient 2 and 1 was -0.1, 95%CI （-0.2, 0.0）, which was statistically significant （P〈0.05）. The Log-Likelihood ratio between Model I and Model Ⅱ h

关 键 词：肺疾病 慢性阻塞性 肺功能 生物燃料 

分 类 号：R56[医药卫生—呼吸系统]