Adams Sandra G, Anzueto Antonio, Pugh Jacqueline A, Lee Shuko, Hazuda Helen P
Department of Medicine, The University of Texas Health Science Center at San Antonio, TX, USA.
Respir Med. 2006 Nov;100(11):1966-72. doi: 10.1016/j.rmed.2006.02.023. Epub 2006 Apr 12.
Hispanics are the fastest growing ethnicity of the US population and the largest subset includes those of Mexican origin. Hispanics, including Mexican Americans (MAs), consistently report less tobacco exposure than European Americans (EAs), but limited data are available regarding differences in the clinical characteristics, severity of airflow obstruction, and functional status between MAs and EAs with chronic obstructive pulmonary disease (COPD).
Participants in a community-based study of aging and frailty among MAs and EAs, San Antonio Longitudinal Study of Aging, underwent spirometry. Participants with spirometry values consistent with COPD by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria are described here.
Thirty-four percent (248/721) of the participants who underwent spirometry had evidence of GOLD Stages 1-4 COPD. Significantly more MAs with COPD reported being never smokers compared to EAs with COPD. Among those with COPD who also smoked, MAs reported significantly less tobacco exposure than EAs (15.7 vs. 32.4 pack-years, respectively), but both groups had surprisingly similar severities of airflow obstruction. Additionally, MAs had worse functional status and perceived health than did EAs.
Despite significantly less exposure to tobacco smoke, MAs with COPD had a similar degree of obstruction to airflow compared with EAs with COPD. Healthcare providers should have a high index of suspicion for COPD in MAs who are exposed to even small amounts of cigarette smoke.
西班牙裔是美国人口中增长最快的种族,其中最大的群体是墨西哥裔。西班牙裔,包括墨西哥裔美国人(MAs),一直报告称其烟草暴露情况少于非西班牙裔白人(EAs),但关于患有慢性阻塞性肺疾病(COPD)的MAs和EAs在临床特征、气流阻塞严重程度和功能状态方面的差异,现有数据有限。
参与一项基于社区的MAs和EAs衰老与虚弱研究(圣安东尼奥衰老纵向研究)的参与者接受了肺活量测定。本文描述了肺活量测定值符合慢性阻塞性肺疾病全球倡议组织(GOLD)标准的COPD参与者。
接受肺活量测定的参与者中有34%(248/721)有GOLD 1-4期COPD的证据。与患有COPD的EAs相比,患有COPD的MAs中报告从不吸烟的比例显著更高。在也吸烟的COPD患者中,MAs报告的烟草暴露量显著少于EAs(分别为15.7包年和32.4包年),但两组的气流阻塞严重程度惊人地相似。此外,MAs的功能状态和自我感知健康状况比EAs更差。
尽管MAs接触烟草烟雾的情况明显较少,但患有COPD的MAs与患有COPD的EAs相比,气流阻塞程度相似。医疗保健提供者对于即使接触少量香烟烟雾的MAs患COPD应保持高度怀疑。