环境空气PM2.5短期暴露与未确诊COPD人群肺功能的关联性  

Associations between Short-term Exposure to Ambient PM2.5 and Lung Function in Undiagnosed COPD Patients

作　　者：汉锋 裴璐[3] 许群 刘喆[1] 王秦[1] 徐东群[1] 陈明浩[4] HAN Feng;PEI Lu;XU Qun;LIU Zhe;WANG Qin;XU Dongqun;CHEN Minghao

机构地区：[1]中国疾病预防控制中心环境与健康相关产品安全所 [2]中国疾病预防控制中心职业卫生与中毒控制所 [3]中国医学科学院基础医学研究所/北京协和医学院基础学院流行病与卫生统计学系 [4]首都医科大学

出　　处：《环境卫生学杂志》2019年第3期197-202,共6页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：卫生行业专项(201502003)

摘　　要：目的分析环境空气中PM2.5短期暴露与未确诊COPD人群肺功能的关联,为该类人群的空气污染防护提供科学依据。方法以肺功能检测筛查的未确诊COPD人群作为受试者;于2018年1、3、8和10月4个时间段,对28名受试者进行了重复测量,包括肺功能检测,及每次测量前5 d的环境PM2.5质量浓度监测、问卷调查;用混合效应模型,分析PM2.5与肺功能的关联性。PM2.5质量浓度对肺功能的影响考虑了滞后效应,按照lag0~lag4滞后日期的浓度代入模型。结果PM2.5日均质量浓度最高为250.46μg/m^3。单日滞后效应结果显示,FEV1、MEF25、MEF50和一秒率与PM2.5的质量浓度在lag1有显著的关联性;PM2.5质量浓度每升高10μg/m^3,FEV1下降0.05 L,MEF25下降0.03 L/s,MEF50下降0.10 L/s,一秒率下降1.09%;FVC、MEF75和PEF与PM2.5质量浓度无关联。滑动平均滞后效应结果中,仅MEF50与PM2.5质量浓度在lag01有一定显著关联性(P<0.1);PM2.5质量浓度每升高10μg/m^3,MEF50下降0.07 L/s。结论环境空气PM2.5可以导致未确诊COPD人群肺功能通气功能指标的下降,应注重此类人群重污染天气的防护。空气污染对小气道的影响更值得关注。Objectives To analyze the associations between short-term exposure to ambient PM2.5 and lung function in undiagnosed COPD population,and to provide a scientific foundation for the protection against air pollution.Methods Subjects were undiagnosed COPD population screened by lung function test.In January,March,August,and October of 2018,28 subjects were tested repeatedly.For each time,lung function testing,questionnaire survey,and the PM2.5 mass concentration monitoring for 5 days before each lung function test were conducted.Mixed effect model was used to analyze the associations between PM2.5 and lung function.The lag effect of PM2.5 mass concentration on lung function was considered,and the lag0~lag4 PM2.5 mass concentration was used in the model.Results The maximum daily PM2.5 mass concentration was 250.46μg/m^3.The result of one-day lag effect showed that FEV1,MEF25,MEF50,and FEV1/FVC were significantly associated with the mass concentration of PM2.5 in lag01.As PM2.5 mass concentration was increased by 10μg/m^3,FEV1,MEF25,MEF50,and FEV1/FVC were decreased by 0.05 L,0.03 L/s,0.10 L/s,and 1.09%,respectively.FVC,MEF75,and PEF were not associated with PM2.5 mass concentration.The moving average lag effect showed that only MEF50 was significantly associated with PM2.5 mass concentration in lag01(P<0.1).As PM2.5 mass was increased by 10μg/m^3,MEF50 was decreased by 0.07 L/s.Conclusions Ambient air PM2.5 can lead to the decline of pulmonary ventilation function indicators in undiagnosed COPD patients,and it is necessary to pay attention to the protection of this group of people against the heavy pollution weather.The impact of air pollution on small airway deserve more attention.

关 键 词：PM2.5 短期暴露 未确诊COPD 肺功能 

分 类 号：R122.7[医药卫生—环境卫生学]