Venditto M A
Department of Internal Medicine, Philadelphia College of Osteopathic Medicine, Pa.
J Am Osteopath Assoc. 1992 Jul;92(7):897-900, 903-5.
Tobacco smoke can alter both the structural and the immunologic defenses of the lungs against infection. The gases from smoke can also inhibit repair of the damages they create. Smokers have been found to have increased bacterial adherence to the respiratory tract, decreased IgA and IgG, and a decrease in vital capacity two to three times greater than that of nonsmokers. These and other respiratory tract alterations put smokers at an added disadvantage when acute lower respiratory tract infections strike. A history of smoking influences the diagnosis of respiratory tract infections because smokers are more prone than nonsmokers to infection by certain organisms. The major causes and characteristics of lower respiratory tract infections, methods of outpatient diagnosis, and the pros and cons of various modes of therapy are discussed.
烟草烟雾会改变肺部抵御感染的结构和免疫防御机制。烟雾中的气体还会抑制其造成的损伤的修复。研究发现，吸烟者呼吸道细菌黏附增加、IgA和IgG减少，肺活量下降幅度比不吸烟者大两到三倍。当急性下呼吸道感染发作时，这些以及其他呼吸道改变使吸烟者处于更不利的境地。吸烟史会影响呼吸道感染的诊断，因为吸烟者比不吸烟者更容易感染某些病原体。本文讨论了下呼吸道感染的主要病因和特征、门诊诊断方法以及各种治疗方式的利弊。
