瑞典中年人群的慢性气流受限、肺气肿和弥散能力受损与吸烟习惯的关系。

Anders Blomberg, Kjell Torén, Per Liv, Gabriel Granåsen, Anders Andersson, Annelie Behndig, Göran Bergström, John Brandberg, Kenneth Caidahl, Kerstin Cederlund, Arne Egesten, Magnus Ekström, Maria J Eriksson, Emil Hagström, Christer Janson, Tomas Jernberg, David Kylhammar, Lars Lind, Anne Lindberg, Eva Lindberg, Claes-Göran Löfdahl, Andrei Malinovschi, Maria Mannila, Lars T Nilsson, Anna-Carin Olin, Anders Persson, Hans Lennart Persson, Annika Rosengren, Johan Sundström, Eva Swahn, Stefan Söderberg, Jenny Vikgren, Per Wollmer, Carl Johan Östgren, Jan Engvall, C Magnus Sköld
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引用次数: 0

摘要

理由慢性阻塞性肺疾病(COPD)包括呼吸系统症状和慢性气流受限(CAL)。在某些病例中,会出现肺气肿和一氧化碳弥散能力(DLCO)受损的情况,但其特征和症状会因吸烟暴露而有所不同:研究中年人群中 CAL、肺气肿和一氧化碳弥散能力受损的发病率与吸烟和呼吸道症状的关系:我们在瑞典的六个地点对 28746 名 50-64 岁的随机受邀者(52% 为女性)进行了调查。我们进行了肺活量测定、DLCO、高分辨率计算机断层扫描(HRCT),并询问了吸烟习惯和呼吸道症状。CAL的定义是支气管扩张后1秒用力呼气量除以用力呼气量(FEV1/FVC)的结果:结果:CAL 的总患病率为 8.8%,DLCO 受损(DLCOConclusions)的总患病率为 8.8%:在这项针对中年人的大型人群研究中,CAL 和 DLCO 受损与常见的呼吸道症状有关。在从不吸烟者中,自我报告的哮喘与 CAL 无关。我们的研究结果表明,从不吸烟者的 CAL 是一种独立的临床表型,可以对其进行监测,并在可能的情况下采取与吸烟相关的慢性阻塞性肺病不同的治疗方法。本文根据知识共享署名 4.0 国际许可协议 (https://creativecommons.org/licenses/by/4.0/) 的条款公开发表。
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Chronic Airflow Limitation, Emphysema, and Impaired Diffusing Capacity in Relation to Smoking Habits in a Swedish Middle-aged Population.

Rationale: Chronic obstructive pulmonary disease (COPD) includes respiratory symptoms and chronic airflow limitation (CAL). In some cases, emphysema and impaired diffusing capacity of the lung for carbon monoxide (DlCO) are present, but characteristics and symptoms vary with smoking exposure. Objective: To study the prevalence of CAL, emphysema, and impaired DlCO in relation to smoking and respiratory symptoms in a middle-aged population. Methods: We investigated 28,746 randomly invited individuals (52% women) aged 50-64 years across six Swedish sites. We performed spirometry, DlCO testing, and high-resolution computed tomography and asked for smoking habits and respiratory symptoms. CAL was defined as post-bronchodilator forced expiratory volume in 1 second divided by forced vital capacity (FEV1/FVC) < 0.7. Results: The overall prevalence was 8.8% for CAL, 5.7% for impaired DlCO (DlCO < LLN), and 8.8% for emphysema, with a higher prevalence in current smokers than in ex-smokers and never-smokers. The proportion of never-smokers among those with CAL, emphysema, and impaired DlCO was 32%, 19%, and 31%, respectively. Regardless of smoking habits, the prevalence of respiratory symptoms was higher among people with CAL and impaired DlCO than those with normal lung function. Asthma prevalence in never-smokers with CAL was 14%. In this group, asthma was associated with lower FEV1 and more respiratory symptoms. Conclusions: In this large population-based study of middle-aged people, CAL and impaired DlCO were associated with common respiratory symptoms. Self-reported asthma was not associated with CAL in never-smokers. Our findings suggest that CAL in never-smokers signifies a separate clinical phenotype that may be monitored and, possibly, treated differently from smoking-related COPD.

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