Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1690, USA.
Respir Med. 2011 Nov;105(11):1682-90. doi: 10.1016/j.rmed.2011.04.016. Epub 2011 May 31.
There are few data concerning changes in lung function and respiratory symptoms in smokers with chronic obstructive pulmonary disease (COPD) weeks to months after quitting smoking. We examined serial changes in spirometry and Clinical COPD Questionnaire (CCQ) scores (measuring respiratory symptoms and health-related quality of life) in COPD participants by smoking status during a smoking cessation trial. In this randomized, double-blind trial, smokers with mild-to-moderate COPD were treated with varenicline 1 mg b.i.d. or placebo for 12 weeks and followed to Week 52. Primary endpoints of abstinence were previously reported. Secondary endpoints were mean changes from baseline in post-bronchodilator forced expired volume in 1 s (FEV(1)) and CCQ scores. Change from baseline in post-bronchodilator FEV(1) was significantly improved in continuous abstainers (121.8 mL) vs. continuous smokers (37.9 mL) at Week 12 (P = 0.0069), but not at Weeks 24 or 52. Mean change from baseline at Week 12 in CCQ Total Score was significantly better in continuous abstainers (-1.04) vs. continuous smokers (-0.53; P < 0.0001): this improvement was sustained at Weeks 24 and 52. In a 1-year cessation trial of smokers with COPD, continuous abstinence compared with continuous smoking significantly improved post-bronchodilator FEV(1) at Week 12 (although the difference narrowed subsequently) and CCQ Total Scores at Week 12, with sustained improvement thereafter. (
http://www.clinicaltrials.gov; trial identifier: NCT00285012).
目的:本研究旨在观察在戒烟后数周至数月,慢性阻塞性肺疾病(COPD)患者戒烟后肺功能和呼吸症状的变化。
方法:在一项戒烟试验中,我们根据患者吸烟状态,检测了 COPD 患者的肺活量测定和临床 COPD 问卷(CCQ)评分(评估呼吸症状和健康相关生活质量)的连续变化。在这项随机、双盲试验中,轻中度 COPD 吸烟者接受了伐尼克兰 1mg bid 或安慰剂治疗 12 周,并随访至第 52 周。之前已经报道了戒烟的主要终点。次要终点是支气管扩张剂后用力呼气量第一秒(FEV1)和 CCQ 评分的基线平均变化。
结果:在第 12 周,持续戒烟者(121.8 mL)与持续吸烟者(37.9 mL)相比,支气管扩张剂后 FEV1 从基线的改善明显更好(P = 0.0069),但在第 24 周和第 52 周则不然。在第 12 周,持续戒烟者的 CCQ 总分从基线的平均变化明显优于持续吸烟者(-1.04 与 -0.53;P < 0.0001):这种改善在第 24 周和第 52 周仍持续。在一项为期 1 年的 COPD 吸烟者戒烟试验中,与持续吸烟相比,持续戒烟在第 12 周时明显改善了支气管扩张剂后 FEV1(尽管随后差距缩小),第 12 周时的 CCQ 总分也有所改善,此后持续改善。
结论:在戒烟后数周至数月,与持续吸烟相比,持续戒烟可显著改善 COPD 患者的肺功能和呼吸症状。