辽宁省男性吸烟者肺功能和6分钟步行距离检测10164例分析

Analysis of pulmonary function and 6MWD among 10164 healthy male smokers in Liaoning province.

目的探讨健康成年男性吸烟、戒烟及不吸烟人群的肺功能改变及6min步行距离（6MWD）情况。方法对2006年8月至2009年6月沈阳市、本溪市、朝阳市、抚顺市、鞍山市、锦洲市6个地区10164例健康成年（35～80岁）男性，进行统一问卷调查及体检，填写问卷后6个月内每隔2个月按常规方法进行肺功能和6MWD测定。结果FEV1、FEV1／FVC％、RV／TCL指标吸烟组与不吸烟组比较，差异有统计学意义（P〈0．05）。MMEF指标吸烟组与戒烟组比较，差异有统计学意义（P〈0．05），吸烟组与不吸烟组比较，差异有统计学意义（P〈0．01），戒烟组与不吸烟组比较，差异有统计学意义（P〈0．05）。6MWD指标吸烟组与戒烟组比较，差异有统计学意义（P〈0．05），与不吸烟组比较，差异有统计学意义（P〈0．01），戒烟组与不吸烟组比较，差异有统计学意义（P〈0．05）。戒烟10年以下与戒烟10年以上比较，FEV，／FVC％差异有统计学意义（P〈0．05），MMEF差异有统计学意义（P〈0．01），6MWD差异有统计学意义（P〈0．05）。结论吸烟者在尚无临床症状时，其肺通气功能已有所降低，尤其是小气道功能，亦即导致肺的储备功能明显降低；戒烟后肺功能会有一定程度的改善，其改善程度与戒烟时间长短有关；因此建议不吸烟，吸烟后应尽早戒烟。

Objective To investigate the alteration in pulmonary function and six-minute walk distance （6MWD） among healthy male current smokers, ex-smokers and non-smokers. Methods Using uniform questionnaire and physical examinations ,a survey for 10164 healthy adult males （aged 35 -80 years） was performed in Shenyang, Benxi, Chaoyang, Fushun, Anshan and Jinzhou. Routine pulmonary function test and measurement of 6MWD were performed for these subjects once every 2 months within 6 months after the survey. Results There were significant differences between the smokers and non-smokers in FEV1, FEV1/FVC% and RV/TCL （all P 〈 0. 05 ）. The MMEF differed significantly between the current smokers and ex-smokers （ P 〈0. 05 ）, between smok-ers and non-smokers （ P 〈 0. 01 ） and between ex-smokers and non-smokers （ P 〈 0. 05 ）. 6MWD was also different between current smokers and ex-smokers （P 〈 0. 05 ）, between current smokers and non-smokers （P 〈 0.01 ） , and between ex-smokers and non-smokers （ P 〈 0. 05 ）. Those who quitted smoking over 10 years before were much better than those did within the previous 10 years in FEV1/FVC% （P 〈 0. 05 ）, MMEF （P 〈 0. 01 ） and 6MWD （ P 〈 0. 05 ）. Conclusion Ventilatory pulmonary function in smokers, particularly the small airway function, may have been damaged early before appearance of clinical manifestations ,which leads to significantly reduced pulmonary reserve function. The pulmonary function may show some improvement after smoking cessation, depending on the length of time from quitting. Therefore we appeal for avoidance of smoking and early cessation of smoking.