Amiot N, Tillon J, Viacroze C, Aouine H, Muir J-F
UPRES EA 3830, IFR MP 23, unité de soins intensifs respiratoires, service de pneumologie et soins intensifs, CHU de Rouen, institut hospitalo-universitaire de recherche bio-médicale, université de Rouen, 76031 Rouen cedex, France.
Rev Mal Respir. 2010 Oct;27(8):907-12. doi: 10.1016/j.rmr.2010.04.009. Epub 2010 May 20.
Fluctuations in atmospheric pollution are responsible for an important morbidity and mortality in the patients suffering from chronic obstructive pulmonary disease (COPD).
Epidemiological studies show a significant increase in the mortality and hospitalization rates in COPD patients in relation to moderate increases in atmospheric pollution. In vitro and in vivo studies demonstrate a pro-inflammatory role and an oxidative toxicity of atmospheric particles and secondary morphological and functional changes in the respiratory epithelium and the immune system. An excess of particulate matter, ozone, NO(2), SO(2) and CO is directly correlated to the number of episodes of acute respiratory failure in different countries all over the world. The mechanisms implicated are complex and variable, dependent on the different pollutant agents, climatic variations and inter-individual susceptibility.
Further experimental studies are necessary in order to clarify our fundamental understanding and, alongside better control of air quality, to reduce short-term respiratory complications.
The consequences of atmospheric pollution fluctuations on the exacerbation rate and therefore on the morbidity and mortality of patients with COPD emphasize the importance of preventive environmental management in the field of public health.
大气污染的波动是导致慢性阻塞性肺疾病（COPD）患者出现严重发病和死亡的原因。
流行病学研究表明，大气污染适度增加会使COPD患者的死亡率和住院率显著上升。体外和体内研究证明，大气颗粒物具有促炎作用和氧化毒性，会导致呼吸道上皮和免疫系统发生继发性形态和功能变化。在世界各国，颗粒物、臭氧、二氧化氮、二氧化硫和一氧化碳过量与急性呼吸衰竭发作次数直接相关。其中涉及的机制复杂多变，取决于不同的污染物、气候变化和个体易感性。
有必要开展进一步的实验研究，以深化我们的基本认识，并在更好地控制空气质量的同时，减少短期呼吸道并发症。
大气污染波动对COPD患者急性加重率以及发病率和死亡率的影响，凸显了公共卫生领域预防性环境管理的重要性。
