戒烟时间与慢性阻塞性肺疾病患者肺功能的相关性及对肺纤毛运动的影响  

Study on the Relationship between Smoking-quitting Time and Pulmonary Function and Its Effect on Pulmonary Ciliary Movement in COPD Patients

作　　者：陈琳[1] 孙瑜 吴宇晗 李艳君 周红 Chen Lin;Sun Yu;Wu Yuhan;Li Yanjun;Zhou Hong(Department of Respiration,The First Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院呼吸科

出　　处：《成都医学院学报》2020年第1期58-61,共4页Journal of Chengdu Medical College

基　　金：国家重点研发计划--重大慢性非传染性疾病防控研究重点专项(No:2017YFC1309400)

摘　　要：目的探讨戒烟时间与慢性阻塞性肺疾病(COPD)患者肺功能的相关性及对肺纤毛运动的影响。方法选取2018年1-12月哈尔滨医科大学附属第一医院收治的300例COPD患者为研究对象,统计患者戒烟时间,并依据戒烟时间分为戒烟≤5年或未戒烟组(n=113)、戒烟6~15年组(n=77)、戒烟≥16年组(n=110),检测并比较3组患者肺功能水平及肺纤毛运动功能;分析戒烟时间长短与COPD患者肺功能的相关性。结果戒烟时3组患者肺功能指标水平比较,差异有统计学意义(P<0.05);戒烟≥16年组患者残气量占肺总量的百分比(RV/TLC)、动脉血二氧化碳分压(PaCO2)、气道阻力占预计值的百分比(Raw%pre)、每年急性发作次数、每年住院次数、每次住院天数、黏膜纤毛清除时间(MCT)等指标水平均显著低于其他两组;每分钟最大通气量(MVV)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、动脉血氧分压(PaO2)、FEV1/FVC、FEV1占预计值百分比(FEV1%pre)等指标水平显著高于其他两组(P<0.01)。Pearson单因素相关性分析表明,MVV、FVC、PaO2、Raw%pre与戒烟时间呈正相关;MCT与戒烟时间、MVV、FEV1%pre、FEV1/FVC呈负相关(P<0.05)。结论吸烟可对COPD患者肺功能造成损害,导致患者通气功能与换气功能下降;戒烟可明显改善患者肺功能及肺纤毛运动功能,降低患者气道阻力与气流受限程度。Objective To explore the relationship between smoking-quitting time and pulmonary function and its effect on pulmonary ciliary movement in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 300 COPD patients admitted to The First Affiliated Hospital of Harbin Medical University from January of 2018 to December of 2018 were selected as the research objects.The time of quitting smoking was counted,and the patients were divided into the group of quitting smoking for no more than 5 years or not(n=113),the group of quitting smoking for 6 to 15 years(n=77)and the group of quitting smoking for no less than 16 years(n=110)according to the time of quitting smoking.The level of patients’pulmonary function and pulmonary ciliary motor function in the three groups were detected and compared,and the correlation between the time of quitting smoking and the pulmonary function of COPD patients was analyzed.Results There were significant differences in the pulmonary function indicators between the three groups(P<0.05).The indicators including the levels of RV/TLC,PaCO2 and Raw%pre,numbers of annual acute attacks,times of annual hospitalization,hospitalization days and mucociliary clearance time(MCT)were significantly lower and the indicators including MVV,FVC,FEV1,PaO2,FEV1/FVC,and FEV1%prep were significantly higher in the group of quitting smoking for no less than 16 years than in the other two groups(P<0.01).According to the Pearson’s single factor correlation analysis,the levels of MVV,FVC,PaO2 and Raw%pre were positively correlated with the time of quitting smoking and MCT was negatively correlated with the time of quitting smoking and the levels of MVV,FEV1%prep and FEV1/FVC(P<0.05).Conclusion Smoking can damage the pulmonary function of COPD patients and lead to the degeneration of ventilation function.Smoking-quitting can obviously improve the pulmonary function and ciliary movement function,which reduces the airway resistance and the degree of airflow limitation in COPD patients.

关 键 词：慢性阻塞性肺疾病 肺功能 肺纤毛运动 戒烟 

分 类 号：R563[医药卫生—呼吸系统]