Allain Y-M, Roche N, Huchon G
Service de pneumologie et réanimation, Hôtel-Dieu, université Paris Descartes, 1, place du Parvis de Notre-Dame, 75004 Paris, France.
Rev Mal Respir. 2010 Apr;27(4):349-63. doi: 10.1016/j.rmr.2010.02.010. Epub 2010 Apr 2.
Tobacco smoking is the leading cause of COPD worldwide but other risk factors have been recognized. Air pollution is one of them, but its exact role in the development of COPD is hard to demonstrate. Its physiological effects on lung function have only been studied since the nineties by long and tedious cohort studies. Difficulties arise from the heterogeneity of air pollution (gas and particles); thus, its respiratory effects have to be examined for every component separately, and in different populations. It is also necessary to analyse the effects of atmospheric pollution in the short and the long term, considering both its physiological, clinical and toxicological effects, from childhood to adulthood. These factors make it difficult to obtain statistically significant results. Nevertheless, most studies seem to point to a role of air pollution in the development of COPD via oxydative stress but further studies are needed to confirm the exact effect of each component of air pollution on the respiratory tract. These studies could lead to improved public health policies and results are awaited that would identify at-risk populations, decide appropriate preventive measures and propose documented thresholds in pollution exposure... thereby limiting the spread of COPD.
吸烟是全球慢性阻塞性肺疾病（COPD）的首要病因，但其他风险因素也已得到确认。空气污染是其中之一，但其在COPD发生发展中的确切作用难以证实。自上世纪九十年代以来，才通过长期且繁琐的队列研究对其对肺功能的生理影响进行研究。困难源于空气污染的异质性（气体和颗粒物）；因此，必须分别针对每个成分以及在不同人群中研究其对呼吸系统的影响。还需要分析短期和长期大气污染的影响，要考虑从儿童到成人阶段其生理、临床和毒理学影响。这些因素使得难以获得具有统计学意义的结果。尽管如此，大多数研究似乎都指出空气污染通过氧化应激在COPD发生发展中起作用，但仍需要进一步研究以确认空气污染各成分对呼吸道的确切影响。这些研究可能会带来更好的公共卫生政策，人们期待能得出相关结果，以确定高危人群、决定适当的预防措施并提出有依据的污染暴露阈值……从而限制COPD的传播。
