石家庄地区空气污染与哮喘患者小气道阻力的相关性研究  

Study on the correlation between air pollution and small airway resistance in patients with asthma in Shijiazhuang area

作　　者：边继美 关继涛[1] 张腾腾 阎锡新[1] 汪冉[3] 李淑云[4] 张旭[1] Bian Jimei;Guan Jitao;Zhang Tengteng;Yan Xixin;Wang Ran;Li Shuyun;Zhang Xu(The First Department of Respiratory and Critical Care Medicine,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;The Third Department of Respiratory Medicine,Hebei Chidren′s Hospital,Shijiazhuang 050000,China;Department of Clinical Lab,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;The Fifth Department of Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院呼吸与危重症医学一科,石家庄050000 [2]河北省儿童医院呼吸三科,石家庄050000 [3]河北医科大学第二医院检验科,石家庄050000 [4]河北医科大学第二医院普外五科,石家庄050000

出　　处：《国际呼吸杂志》2020年第14期1041-1047,共7页International Journal of Respiration

基　　金：河北省2019年度医学科学研究课题(20190507)。

摘　　要：目的探索石家庄地区空气污染对支气管哮喘(哮喘)患者小气道功能变化的影响,分析小气道指标变化与空气中相关污染因子的相关性。方法选取2018年7月至2019年1月于河北医科大学第二医院呼吸与危重症医学一科门诊复诊2次的石家庄地区的哮喘患者作为研究对象,将他们的肺功能指标按空气污染程度分为空气污染组和空气优良组。分析2组数据的统计学差异。同时对小气道指标与各污染因子、空气质量指数(AQI)与各污染因子进行多元线性回归分析。结果比较2组的各小气道指标,空气污染组均值明显低于空气优良组。用力呼出50%肺活量的呼气流量占预计值百分比(FEF50%%pred)与检测日前一天的空气质量指数(AQI-1)(AQI-0为患者检测当天的AQI值,AQI-1为检测日前一天的AQI值,以此类推)呈负相关(P<0.05);呼气中期流量占预计值百分比(FEF25%-75%%pred)与AQI-1呈负相关(P<0.05);检测日前一天的二氧化硫浓度(SO2)(SO2-0为患者检测当天的SO2值,SO2-1为检测日前一天的SO2值,以此类推)与用力呼出75%肺活量的呼气流量占预计值百分比(FEF75%%pred)、FEF25%-75%%pred呈正相关(P<0.05);检测日前两天的臭氧浓度(O3-2)(O3-0为患者检测当天的O3值,O3-1为检测日前一天的O3值,以此类推)与FEF50%%pred呈正相关(P<0.05)。各小气道指标与AQI-0、AQI-2均无相关性;细颗粒物(PM2.5)、可吸入颗粒物(PM10)等其余单一污染因子与小气道指标间无相关性。空气污染组的第1秒用力呼气容积占预计值百分比(FEV1%pred)明显比空气优良组低。结论AQI值越高,哮喘患者气道阻塞程度越严重,FEV1%pred值越低,各个小气道指标越低,部分哮喘患者的气道反应性越敏感。以AQI值为标准研究大气污染物对小气道功能影响时,比其他单一污染因子更为合理,采用PM2.5、PM10等单一污染因子无法预测哮喘患者小气道指标变化。Objective To explore the influence of air pollution in Shijiazhuang on the changes of small airway function in asthmatic patients,and to analyze the correlation between the change of small airway index and air pollution factors.Methods Asthma patients in Shijiazhuang who had been revisited twice in the First Department of Rehabilitation Medicine of the Second Hospital of Hebei Medical University,from July 2018 to January 2019 were selected as research objects,and their lung function indexes were divided into the air pollution group and the air quality group according to the air pollution degree.Statistical differences between the two groups were analyzed.At the same time,multiple linear regression analysis was carried out between the indicators of small airway and each pollution factor,air quality index(AQI)and other pollution factors.Results The mean value of the air pollution group was significantly lower than that of the air quality group.Forced exhalation of 50%of vital expiratory flow at 50%of FVC as a percentage of expected value(FEF50%%pred)is negatively correlated with the the day before the test date of air quality index(AQI-1),(AQI-0 is the AQI value on the day of test,and AQI-1 is the AQI value on the day before test,and so on)(P<0.05).Mid expiratory flow forced expiratory flow25%-75%as a percentage of expected value(FEF25%-75%%pred)is negatively correlated with AQI-1(P<0.05).The day before the test date of sulfur dioxide levels(SO2)(SO2-0 is the SO2 value on the day of the patient′s test,SO2-1 is the SO2 value on the day before the test day,and so on)are positively correlated with FEF75%%pred and FEF25%-75%%pred(P<0.05).The ozone concentration two days before the test date(O3-2)(O3-0 is the O3 value of the patient on the day of the test,O3-1 is the O3 value of the day before the test,and so on)is positively correlated with FEF50%%pred(P<0.05).There was no correlation between each small airway index and AQI-0 and AQI-2.Fine particulate matter(PM2.5),inhalable particles(PM10),such as the rest of the s

关 键 词：哮喘 空气污染 肺功能 小气道 

分 类 号：X51[环境科学与工程—环境工程]