短期臭氧暴露致健康老年人呼吸系统效应的定组研究  

Respiratory effects of short-term exposure to ozone in a panel of healthy elderly

作　　者：孙贝贝 宋杰 姜静 王亚 李娟 安珍[1] 张艳格 王贵 李慧君[1] 杨富云 张锐 吴卫东[1] SUN Beibei;SONG Jie;JIANG Jing;WANG Ya;LI Juan;AN Zhen;ZHANG Yange;WANG Gui;LI Huijun;YANG Fuyun;ZHANG Rui;WU Weidong(School of Public Health,Xinxiang Medical University,Xinxiang,Henan 453003,China)

机构地区：[1]新乡医学院公共卫生学院,河南新乡453003

出　　处：《环境与职业医学》2021年第2期125-131,共7页Journal of Environmental and Occupational Medicine

基　　金：国家自然科学基金项目(81573112)。

摘　　要：[背景]空气污染是国内外较为关注的主要公共卫生问题,近年来臭氧(O_(3))浓度呈逐渐升高趋势,其对机体健康的影响不容忽视。[目的]了解O_(3)诱导的急性呼吸系统作用,以及谷胱甘肽硫转移酶T1(GSTT1)基因对该效应的影响。[方法]采用定组研究设计,招募新乡医学院健康退休教职工,根据纳入标准确定研究对象,于2018年12月—2019年4月进行5次随访调查(4周·次^(-1)),检测指标包括肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)]和气道炎症指标[呼出气一氧化氮(FeNO)以及鼻腔黏液中炎性因子白介素8(IL-8)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]和氧化应激指标[8-异构前列腺素(8-epi-PGF2α)];结合空气监测站的O_(3)小时浓度数据资料和体检时间点,估算个体的日均浓度,采用线性混合效应模型分析O_(3)浓度(lag0~lag4及lag01~lag04)对健康效应指标的影响,同时以GSTT1基因分层比较效应差异,探讨GSTT1多态性对O_(3)诱导的健康效应的影响。[结果]研究共纳入32名老年健康志愿者,平均年龄(63.53±5.76)岁,平均体重指数为(26.30±3.36)kg·m^(-2),GSTT1基因表达者共20例(占62.5%),GSTM1、GSTP1基因均全部表达。O_(3)质量浓度(简称浓度)为18.96~60.92μg·m^(-3),平均浓度为(36.91±13.88)μg·m^(-3);温度为(6.10±6.77)℃;相对湿度为(43.92±9.50)%。研究对象四种生物指标(IL-1β,IL-8,TNF-α和8-epi-PGF2α)平均浓度分别为(179.61±126.67)、(49.67±38.19)、(0.49±0.31)和(41.64±20.94)μg·L^(-1);FeNO平均浓度为(28.10±9.96)ppb;肺功能FVC、FEV_(1)、FEV_(1)/FVC、PEF和MV分别为(2.49±0.53)L、(2.15±0.47)L、(0.87±0.06)L·s^(-1)、(4.19±1.54)L·s^(-1)和(7.78±2.75)L。分析结果显示,单污染物模型中O_(3)浓度每增加10μg·m^(-3),lag3时IL-1β水平增加79.36%(95%CI:1.86%~156.85%);除O_(3)+PM_(2.5)模型外,其余双污染物模型均无统计学意义。基因分层分析表明,GSTT1(+)[Background] Air pollution is a major public health problem widely concerned. In recent years, the growing concentration of ozone(O_(3)) in association with human health effects cannot be ignored.[Objective] This study aims to investigate acute adverse human respiratory effects of O_(3) and to determine whether glutathione S-transferase-theta 1(GSTT1) gene modifies those effects. [Methods] Healthy and retired teaching staff of Xinxiang Medical College who met the inclusion criteria were enrolled in the study, and were followed up five times(once every four weeks) from December 2018 to April 2019. Detection indicators were lung function indicators, including forced vital capacity(FVC), forced expiratory volume in one second(FEV_(1)), and peak expiratory flow(PEF);airway inflammation indicators, such as fractional exhaled nitric oxide(Fe NO),interleukin-8(IL-8), interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α) in nasal samples;and oxidative stress indicator, namely 8-epi-prostaglandin F2 alpha(8-epi-PGF2α). Daily average concentrations of individual exposure were calculated by hourly concentration of O_(3) and meteorological factors recorded by fixed monitoring sites. Linear mixed-effect model was used to analyze the relationship between O_(3) concentration(lag0-lag4 and lag01-lag04) and respiratory effects, and then the potential modifying effects of GSTT1 polymorphism were studied by stratification analysis. [Results] A total of 32 elderly healthy volunteers were enrolled in the study, with an average age of(63.53±5.76) years and an average body mass index(BMI) of(26.30±3.36) kg·m^(-2). There were 20 cases(62.5%) with GSTT1 gene expression, 32 cases(100%) with GSTM1 gene expression, and 32 cases(100%) with GSTP1 gene expression. The O_(3) concentration was 18.96-60.92 μg·m^(-3), and the average concentration was(36.91±13.88) μg·m^(-3);the temperature was(6.10±6.77) ℃;the relative humidity was(43.92±9.50)%. The average concentrations of four biological indicators(IL-1β, IL-8, TNF-α, and

关 键 词：臭氧 肺功能 呼吸道炎症 氧化应激 谷胱甘肽硫转移酶T1 

分 类 号：R12[医药卫生—环境卫生学]