Shin Chol, Lee Sungim, Abbott Robert D, Kim Je Hyeong, Lee Sang Yeub, In Kwang Ho, Kimm KuChan
Department of Internal Medicine, School of Medicine, Korea University, Seoul.
Lung. 2005 Sep-Oct;183(5):301-9. doi: 10.1007/s00408-004-2543-y.
Although the prevalence of chronic obstructive pulmonary disease (COPD) and its relationship with respiratory symptoms are well documented, few studies have focused on individuals with normal lung function, particularly in developed regions of Asia. The purpose of this report is to examine the relationship between respiratory symptoms and FEV1 in a population-based sample of Korean men and women with normal lung function. Subjects comprised 7518 individuals aged 40-69 years without airflow obstruction based on spirometric testing and in the absence of a medical history of pulmonary disease. Respiratory symptoms included chronic cough, chronic phlegm, wheezing, and shortness of breath. In men, the age-adjusted mean FEV1 was lower by 165 ml in smokers and 133 ml in nonsmokers in the presence versus the absence of wheezing (p < 0.05). While walking at a usual pace, FEV1 in smoking men was 210 ml lower in the presence versus the absence of shortness of breath (p < 0.05). Among nonsmoking men, overall shortness of breath and shortness of breath while walking uphill were associated with a lower FEV1 by 56 and 80 ml, respectively) versus those who reported having no shortness of breath (p < 0.05). Respiratory symptoms were unrelated to FEV1 in women smokers, although only 3.5% smoked cigarettes. In nonsmoking women, FEV1 was lower by an average of 89 ml in the presence versus the absence of wheezing (p < 0.001). Nonsmoking women also had a lower FEV1 in the presence of shortness of breath (overall, while at rest, and while walking uphill or at a usual pace, p < 0.001). Our findings suggest that respiratory symptoms are associated with a lower FEV1 in men and nonsmoking women with normal lung function. Whether respiratory symptoms can be used to identify individuals at risk for developing COPD needs further study.
尽管慢性阻塞性肺疾病(COPD)的患病率及其与呼吸道症状的关系已有充分记录,但很少有研究关注肺功能正常的个体,尤其是在亚洲发达地区。本报告的目的是在一个基于人群的韩国男女肺功能正常样本中,研究呼吸道症状与第一秒用力呼气容积(FEV1)之间的关系。研究对象包括7518名年龄在40 - 69岁之间、根据肺活量测定无气流阻塞且无肺部疾病病史的个体。呼吸道症状包括慢性咳嗽、慢性咳痰、喘息和气短。在男性中,与无喘息者相比,有喘息的吸烟者年龄调整后的平均FEV1低165毫升,无喘息的吸烟者低133毫升(p < 0.05)。在以平常速度行走时,有气短的吸烟男性的FEV1比无气短者低210毫升(p < 0.05)。在不吸烟男性中,总体气短和上坡行走时气短分别与FEV1降低56毫升和80毫升相关(与无气短者相比,p < 0.05)。女性吸烟者的呼吸道症状与FEV1无关,尽管只有3.5%的女性吸烟。在不吸烟女性中,与无喘息者相比,有喘息时FEV1平均低89毫升(p < 0.001)。不吸烟女性在有气短时(总体、休息时、上坡行走或平常速度行走时)FEV1也较低(p < 0.001)。我们的研究结果表明,呼吸道症状与肺功能正常的男性和不吸烟女性的较低FEV1相关。呼吸道症状是否可用于识别有患COPD风险的个体需要进一步研究。