氢气对环卫工人雾霾暴露肺保护性作用的研究

Protective effect of hydrogen on the lung of sanitation workers exposed to haze

目的 探讨氢气吸入对环卫工人雾霾暴露的肺保护性作用.方法 2016年1—2月选取石家庄市中心城区96名健康不吸烟环卫工人为研究对象,采用随机、对照、双盲的方法,将研究对象分为试验组（50名）及对照组（46名）.试验组给予吸入氢氧混合气（67%/33%）治疗,对照组给予吸入氮氧混合气（67%/33%）治疗,1 h/次,1次/d,为期30 d.分别在试验前1天（第0天）、试验开始第8、15及30天留取血样、诱导痰液、测定肺功能及呼出气一氧化氮（FeNO）,问卷调查及随访受试对象自觉症状改善情况.结果 （1）第8天试验组FeNO测定值为（16±5）×109,明显低于对照组的（21±14）×109（F=6.94,P〈0.05）;（2）第8天试验组FEV1占预计值%为（96±13）%,高于对照组的（94±14）%（F=3.96,P〈0.05）;第30天试验组FEV1占预计值%为（97±14）%,高于对照组的（95±12）%（F=8.5,P〈0.05）;第15天试验组PEF占预计值%为（73±15）%,高于对照组的（67±18）%（F=8.68,P〈0.05）;（3）痰上清液中,试验组第8、15、30天基质金属蛋白酶（MMP）-12与超氧化物歧化酶3（SOD3）低于对照组,第15、30天IL-10高于对照组,第30天丙二醛及IL-2低于对照组（均P〈0.05）.两组痰液中C反应蛋白（CRP）、转化生长因子（TGF）-β1差异无统计学意义（均P〉0.05）;（4）血清中,试验组第8、15、30天IL-2与SOD3低于对照组,IL-10高于对照组,第30天MMP-12低于对照组（均P〈0.05）.血清中CRP、TGF-β1、丙二醛各观察点两组比较差异无统计学意义（均P〉0.05）;（5）试验组结束治疗后咳嗽等呼吸系统症状得到明显改善.结论 氢气吸入治疗有助于降低气道氧化应激损伤相关炎性水平,对全身炎症反应可能也有一定抑制效果,同时能够改善环卫工人咳嗽等呼吸系统症状.

Objective To study the protective effect of hydrogen inhalation on the lungs of sanitation workers exposed to haze .Methods In this randomized, double-blind, placebo controlled clinical trial, 96 sanitation workers living in Shijiazhuang urban area were recruited during January to February , 2016.All enrolled participants were randomized to 2 groups; the treatment group inhaled H 2：O2 mixture （66.67%：33.33%） 1 hour per day for 30 days, while the control group inhaled N 2 ：O2 mixture （66.67%：33.33%） 1 hour per day for 30 days.Respiratory symptoms were evaluated and fractional exhaled nitric oxide（FeNO）, biochemical indexes, lung function were measured at baseline （the 0th day） and during treatment （ the 8th day, 15th day, and 30th day ） .Results （ 1 ） The FeNO levels of the treatment group （16 ±5） ×109 were lower than those of the control group （21 ±14） ×109 on 8th day of treatment, with significant difference（F=6.94,P〈0.05）.（2）The levels of FEV1 were significantly higher in participants from the treatment group as compared to the control group on both 8th [（96 ±13）%vs（94 ± 14）%（F=3.96,P 〈0.05）] and 30th day [（97 ±14）% vs （95 ±12）%（ F =8.5,P 〈0.05）] of treatment, while PEF was also increased on 15th day [（73 ±15）%vs（67 ±18）%（F=8.68,P〈0.05）]. （3） The sputum levels of MMP-12 and SOD3 were consistently lower in the treatment group as compared to the control group at each time point , and the levels of IL-10 were higher in the treatment group as compared to the control group on the 15th and 30th day.MDA and IL-2 levels were lower in the treatment group than in the control group on the 30th day（P〈0.05）.The sputum levels of CRP and TGF-β1 at each time point were not different between the 2 groups （P〉0.05）.（4）The serum levels of IL-2 and SOD3 were lower in the treatment group as compared to the control group while IL-10 was higher than in the control group at each time point, and MMP-12 was lower in the treatment group than that in the control group on the 30th day（P〈0.05）.The relative ratios of CRP, TGF-β1 and MDA in serum at each time point between the 2 groups were not significantly different （ P 〉0.05 ） .（ 5 ） Hydrogen inhalation improved respiratory symptoms such as cough.Conclusions Inhalation of hydrogen gas could alleviate airway inflammation and oxidative stress of sanitation workers exposed to air pollution .There was even a significant inhibitory effect on the level of systemic inflammatory response.Importantly, inhalation of hydrogen could improve respiratory symptoms such as cough.