Yates D H, Breen H, Thomas P S
Department of Respiratory Medicine, Concord Repatriation General Hospital, Concord, NSW, Australia.
Am J Respir Crit Care Med. 2001 Sep 15;164(6):1043-6. doi: 10.1164/ajrccm.164.6.2005043.
Environmental tobacco smoke (ETS) exposure is one of the commonest pollutants in modern society. Despite documented clinical adverse effects of ETS on the lungs, objective methods of assessing airway damage have been lacking. Exhaled nitric oxide (eNO) is a rapid, sensitive method of assessing airway inflammation, and could be useful in this regard. Active smoking decreases eNO in normal subjects and eNO levels are low in habitual smokers, but the effect of ETS exposure on eNO has not previously been examined. In a single-blinded, placebo-controlled cross-over study, we examined the effect of ETS, sham and active smoke inhalation on eNO in non-smoking normal volunteers. Subjects were exposed to smoke over a period of 1 hour in a separately ventilated chamber, and eNO was measured at baseline, 15, 30, 45 and 60 minutes. With sham inhalation (n = 15), eNO levels did not change significantly from baseline, although a small decrease occurred. ETS exposure (n = 15) resulted in a rapid fall in eNO from mean (SE) 134 (29) ppb to 102 (22) ppb, or by 23.6% (p < 0.05), and remained low for 60 minutes. With active smoking (n = 7), levels fell acutely from baseline within the same time interval (71 [16] to 49 [11] ppb, or by 30.3%), and remained low. These changes were significant compared with sham exposure for both ETS (p < 0.05) and active smoke inhalation (p <.01). This suggests that eNO can be used for the investigation of the mechanisms of cigarette-induced lung damage in the experimental setting, and may potentially be useful also for environmental assessment of ETS effects.
环境烟草烟雾（ETS）暴露是现代社会中最常见的污染物之一。尽管有文献记载ETS对肺部有临床不良影响，但一直缺乏评估气道损伤的客观方法。呼出一氧化氮（eNO）是一种快速、灵敏的评估气道炎症的方法，在这方面可能会有用。主动吸烟会降低正常受试者的eNO水平，习惯吸烟者的eNO水平较低，但此前尚未研究过ETS暴露对eNO的影响。在一项单盲、安慰剂对照的交叉研究中，我们研究了ETS、假烟雾和主动吸烟吸入对不吸烟正常志愿者eNO的影响。受试者在一个单独通风的室内暴露于烟雾中1小时，并在基线、15、30、45和60分钟时测量eNO。假吸入（n = 15）时，尽管有小幅下降，但eNO水平与基线相比无显著变化。ETS暴露（n = 15）导致eNO从平均（标准误）134（29）ppb迅速降至102（22）ppb，即下降23.6%（p < 0.05），并在60分钟内保持较低水平。主动吸烟（n = 7）时，水平在相同时间间隔内从基线急剧下降（71 [16]至49 [11] ppb，即下降30.3%），并保持较低水平。与假暴露相比，这些变化在ETS（p < 0.05）和主动吸烟吸入（p < 0.01）时均具有显著性。这表明eNO可用于在实验环境中研究香烟诱导的肺损伤机制，并且可能对ETS影响的环境评估也有潜在用途。
