Yeatts Karin, Svendsen Erik, Creason John, Alexis Neil, Herbst Margaret, Scott James, Kupper Lawrence, Williams Ronald, Neas Lucas, Cascio Wayne, Devlin Robert B, Peden David B
Center for Environmental Medicine, Asthma, and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina 27599-7310, USA.
Environ Health Perspect. 2007 May;115(5):709-14. doi: 10.1289/ehp.9499. Epub 2007 Jan 18.
We investigated whether markers of airway and systemic inflammation, as well as heart rate variability (HRV) in asthmatics, change in response to fluctuations in ambient particulate matter (PM) in the coarse [PM with aerodynamic diameter 2.5-10 microm (PM(2.5-10))] and fine (PM(2.5)) size range.
Twelve adult asthmatics, living within a 30-mile radius of an atmospheric monitoring site in Chapel Hill, North Carolina, were followed over a 12-week period. Daily PM(2.5-10) and PM(2.5) concentrations were measured separately for each 24-hr period. Each subject had nine clinic visits, at which spirometric measures and peripheral blood samples for analysis of lipids, inflammatory cells, and coagulation-associated proteins were obtained. We also assessed HRV [SDNN24HR (standard deviation of all normal-to-normal intervals in a 24-hr recording), ASDNN5 (mean of the standard deviation in all 5-min segments of a 24-hr recording)] with four consecutive 24-hr ambulatory electrocardiogram measurements. Linear mixed models with a spatial covariance matrix structure and a 1-day lag were used to assess potential associations between PM levels and cardiopulmonary end points.
For a 1-microg/m(3) increase in coarse PM, SDNN24HR, and ASDNN5 decreased 3.36% (p = 0.02), and 0.77%, (p = 0.05) respectively. With a 1-microg/m(3) increase in coarse PM, circulating eosinophils increased 0.16% (p = 0.01), triglycerides increased 4.8% (p = 0.02), and very low-density lipoprotein increased 1.15% (p = 0.01). No significant associations were found with fine PM, and none with lung function.
These data suggest that small temporal increases in ambient coarse PM are sufficient to affect important cardiopulmonary and lipid parameters in adults with asthma. Coarse PM may have underappreciated health effects in susceptible populations.
我们研究了哮喘患者气道和全身炎症标志物以及心率变异性(HRV)是否会随着环境中粗颗粒(空气动力学直径为2.5 - 10微米的颗粒物[PM(2.5 - 10)])和细颗粒(PM(2.5))粒径范围内颗粒物(PM)的波动而变化。
对居住在北卡罗来纳州教堂山一个大气监测站点半径30英里范围内的12名成年哮喘患者进行了为期12周的跟踪研究。每天分别测量每个24小时时间段内的PM(2.5 - 10)和PM(2.5)浓度。每位受试者进行了9次门诊就诊,期间获取了肺功能测量值以及用于分析脂质、炎症细胞和凝血相关蛋白的外周血样本。我们还通过连续4次24小时动态心电图测量评估了HRV [SDNN24HR(24小时记录中所有正常到正常间期的标准差),ASDNN5(24小时记录中所有5分钟时间段标准差的平均值)]。采用具有空间协方差矩阵结构和1天滞后的线性混合模型来评估PM水平与心肺终点之间的潜在关联。
粗颗粒PM每增加1微克/立方米,SDNN24HR和ASDNN5分别下降3.36%(p = 0.02)和0.77%(p = 0.05)。粗颗粒PM每增加1微克/立方米,循环嗜酸性粒细胞增加0.16%(p = 0.01),甘油三酯增加4.8%(p = 0.02),极低密度脂蛋白增加1.15%(p = 0.01)。未发现与细颗粒PM有显著关联,也未发现与肺功能有显著关联。
这些数据表明,环境中粗颗粒PM在短时间内的小幅增加足以影响成年哮喘患者重要的心肺和脂质参数。粗颗粒PM对易感人群的健康影响可能未得到充分认识。