Piitulainen E, Eriksson S
Dept of Lung Medicine, Lund University, University Hospital, Malmö, Sweden.
Eur Respir J. 1999 Feb;13(2):247-51. doi: 10.1183/09031936.99.13224799.
Severe alpha1-antitrypsin (AAT) deficiency predisposes to emphysema development. Highly variable rates of decline in lung function are reported in PiZZ individuals. The annual decline in forced expiratory volume in one second (FEV1; delta FEV1) was analysed in relation to smoking status in a cohort of 608 adult PiZZ individuals included in the Swedish national AAT deficiency register. Delta FEV1 was analysed in 211 never-smokers, in 351 exsmokers, and in 46 current smokers after performing at least two spirometries during a follow-up time of 1 yr or longer (median 5.5 yrs, range 1-31). The adjusted mean delta FEV1 in never-smokers was 47 mL x yr(-1) (95% confidence interval (CI) 41-53 mL x yr(-1)), 41 mL x yr(-1) (95% CI 36-48 mL x yr(-1)) in exsmokers, and 70 mL x yr(-1) (95% CI 58-82 mL x yr(-1)) in current smokers. A dose-response relationship was found between cigarette consumption and delta FEV1 in current smokers and exsmokers. In never-smokers, a greater delta FEV1 was found after 50 yrs of age than before. No sex differences were found in delta FEV1. In conclusion, among PiZZ individuals, the change in forced expiratory volume in one second is essentially the same in never-smokers and exsmokers. Smoking is associated with a dose-dependent increase in the change in forced expiratory volume in one second.
严重的α1-抗胰蛋白酶（AAT）缺乏易导致肺气肿的发生。据报道，PiZZ个体的肺功能下降速率差异很大。在纳入瑞典国家AAT缺乏登记册的608名成年PiZZ个体队列中，分析了一秒用力呼气量（FEV1；ΔFEV1）的年下降率与吸烟状况的关系。在1年或更长时间（中位时间5.5年，范围1 - 31年）的随访期间进行至少两次肺量测定后，对211名从不吸烟者、351名既往吸烟者和46名当前吸烟者的ΔFEV1进行了分析。从不吸烟者的校正后平均ΔFEV1为47 mL·yr⁻¹（95%置信区间（CI）41 - 53 mL·yr⁻¹），既往吸烟者为41 mL·yr⁻¹（95%CI 36 - 48 mL·yr⁻¹），当前吸烟者为70 mL·yr⁻¹（95%CI 58 - 82 mL·yr⁻¹）。在当前吸烟者和既往吸烟者中，发现香烟消费量与ΔFEV1之间存在剂量反应关系。在从不吸烟者中，50岁以后的ΔFEV1比之前更大。在ΔFEV1方面未发现性别差异。总之，在PiZZ个体中，从不吸烟者和既往吸烟者的一秒用力呼气量变化基本相同。吸烟与一秒用力呼气量变化的剂量依赖性增加有关。
