Harmsen Lotte, Gottlieb Vibeke, Makowska Rasmussen Linda, Backer Vibeke
Respiratory and Allergy Research Unit, Department of Respiratory Medicine L, Copenhagen University Hospital Bispebjerg, Denmark.
J Asthma. 2010 May;47(4):362-6. doi: 10.3109/02770901003692819.
The frequency of smokers among asthma patients often mirrors the frequency of smokers among healthy individuals. Smoking has been shown to increase the lung function decline in adult asthma patients and change the composition of the bronchial inflammation.
To examine the consequences of smoking in a large cohort of young asthma patients.
Seven hundred ninety-three asthma patients, aged 14 to 44, were examined using lung function measurements, bronchial provocations, clinical interviews, and questionnaires.
Forty-five percent of participants were smokers; smokers had significantly lower forced expiratory volume in one second (FEV(1)), FEV(1) in percent of predicted value (FEV(1)% pred), and FEV(1)/forced vital capacity (FVC) values compared with nonsmokers, and there was a dose-response relationship between tobacco exposure and these lung function measures. Smoking seemingly affected the FEV(1) growth already in adolescence, and before the age of 45, significantly more smokers than nonsmokers had signs of airflow limitation, with FEV(1)/FVC ratios below 0.70. Smokers had more asthma symptoms despite receiving inhaled corticosteroid (ICS) treatment as frequently as did nonsmokers.
The additive effect of smoking on lung function decline in asthma patients is detectable at early ages and leads to signs of airflow limitation before the age of 45 years.
哮喘患者中吸烟者的比例往往与健康个体中吸烟者的比例相似。吸烟已被证明会加剧成年哮喘患者的肺功能下降，并改变支气管炎症的构成。
研究大量年轻哮喘患者吸烟的后果。
对793名年龄在14至44岁之间的哮喘患者进行了肺功能测量、支气管激发试验、临床访谈和问卷调查。
45%的参与者为吸烟者；与不吸烟者相比，吸烟者的一秒用力呼气量（FEV₁）、FEV₁占预测值的百分比（FEV₁%pred）以及FEV₁/用力肺活量（FVC）值显著更低，并且烟草暴露与这些肺功能指标之间存在剂量反应关系。吸烟似乎在青少年时期就已影响FEV₁的增长，在45岁之前，有气流受限体征（FEV₁/FVC比值低于0.70）的吸烟者显著多于不吸烟者。尽管吸烟者和不吸烟者接受吸入性糖皮质激素（ICS）治疗的频率相同，但吸烟者的哮喘症状更多。
吸烟对哮喘患者肺功能下降的叠加效应在早年即可检测到，并在45岁之前导致气流受限体征。
