辽宁省六城市7515名吸烟人群的肺功能检测分析

Lung functions in 7 515 smokers from Liaoning province

目的通过检测吸烟人群与非吸烟人群的肺功能,探讨吸烟对肺功能的影响。方法对辽宁省6个城市26324人采用统一问卷调查及体格检查,经筛选和剔除后,对无症状的7515名吸烟者及6469名非吸烟者进行问卷调查后的6个月内,由固定技师每隔2个月应用同型号肺功能仪检测肺功能,连续3次,取均值,并对测定结果进行比较分析。结果吸烟组与非吸烟组间以及轻、中、重组间的功能残气量(ERV)、残气量(RV)、深吸气量(IC)、肺活量(VC)、RV/肺总量(TCL)的差异均无统计学意义(P值均>0.05)。肺通气功能比较:吸烟组的1秒钟用力呼气容积(FEV1)占预计值百分比、FEV1/用力呼气肺活量(FVC)占预计值百分比均较非吸烟组显著降低(P值均<0.05),而MVV占预计值百分比和FVC占预计值百分比的差异均无统计学意义(P值均>0.05);轻、中、重组间MVV占预计值百分比和FVC占预计值百分比的差异均无统计学意义(P值均>0.05),而轻组与重组间FEV1占预计值百分比、FEV1/FVC占预计值百分比的差异均有统计学意义(P值分别为<0.01、0.05),中组与重组间FEV1占预计值百分比的差异有统计学意义(P<0.05)。吸烟组反应小气道功能[25%呼气流速(FEF25%)、50%呼气流速(FEF50%)、75%呼气流速(FEF75%)、中段呼气流速(MMEF)]的各项指标均较非吸烟组显著增高(P值分别<0.05、0.01);轻组与重组间FEF25%、FEF50%、FEF75%的差异均有统计学意义(P值均<0.05),轻组与重组间MMEF的差异有统计学意义(P<0.01)。结论吸烟者在尚无临床症状时,其肺通气功能已降低,随着吸烟年限和数量的增加,肺功能的损害也越严重。

Objective To investigate the influence of smoking on the lung functions. Methods Uniform questionnaire and physical examinations were applied in 26 324 people from six cities of Liaoning province. By Spiro meters （medisoft N5000）, lung function tests were analyzed in 7 515 asymptomatic smokers and 6 469 non-smokers for three times within six months. The unpaired t test was applied for statistic analysis. Results There were no significant differences in the mean values of functional residual capacity （FRC）, residual volume （RV）, inspiratory capacity （IC）, vital capacity （VC） or RV/total lung capacity （TCL） between smokers and non-smokers （P〉0.05）, and among the mild, moderate and severe groups （P〉0.05）. The ventilation functions presented that forced expiratory volume in one second of a forced expiratory maneuvery （FEV1,%） and FEV1/force vital capacity （FVC, %） were obviously decreased in smokers than in non-smokers （P〈0.05）, but no significant difference was seen in maximum ventilatory volume （MVV, %） and FVC（%） between the two groups （P〉0.05）. There was also no significant difference in these two values among the mild, moderate and severe groups （P〉0.05）, but significant differences were found in FEV1（%） and FEV1/FVC（%） between mild and severe groups （P〈0.05, 0.01） and also in FEV1（%） between moderate and severe groups （P〈0.05）. All the indices for small airway functions （expiratory flow rates： FEF 25%, FEF 50%, FEF 75%, and maximum mid-expiratory flow [MMEF]） was damaged more obviously in smokers than non-smokers （P〉0.05, 0.01）. Significant differences were found in FEF 25%, FEF 50%, FEF 75% and MMEF between the mild and severe groups （P〉0.05, 0.01）. Conclusions The ventilation functions, especially the small airway functions, have already been damaged in smokers before any clinical manifestations, which is positively correlated with smoking history and times.