Department of Respiratory Medicine, Division of Heart & Lungs, University Medical Center Utrecht, Utrecht, the Netherlands.
Respir Res. 2013 May 20;14(1):55. doi: 10.1186/1465-9921-14-55.
Little is known about the factors associated with CT-quantified emphysema progression in heavy smokers. The objective of this study was to investigate the effect of length of smoking cessation and clinical / demographical factors on the rate of emphysema progression and FEV1-decline in male heavy smokers.
3,670 male smokers with mean (SD) 40.8 (17.9) packyears underwent chest CT scans and pulmonary function tests at baseline and after 1 and 3 years follow-up. Smoking status (quitted ≥5, ≥1-<5, <1 years or current smoker) was noted. Rate of progression of emphysema and FEV1-decline after follow-up were assessed by analysis of variance adjusting for age, height, baseline pulmonary function and emphysema severity, packyears, years in study and respiratory symptoms. The quitted ≥5 group was used as reference.
Median (Q1-Q3) emphysema severity,<-950 HU, was 8.8 (5.1 - 14.1) and mean (SD) FEV1 was 3.4 (0.73) L or 98.5 (18.5) % of predicted. The group quitted '>5 years' showed significantly lower rates of progression of emphysema compared to current smokers, 1.07% and 1.12% per year, respectively (p<0.001). Current smokers had a yearly FEV1-decline of 69 ml, while subjects quit smoking >5 years had a yearly decline of 57.5 ml (p<0.001).
Quit smoking >5 years significantly slows the rate of emphysema progression and lung function decline.
Registered at http://www.trialregister.nl with trial number ISRCTN63545820.
对于与长期大量吸烟者 CT 量化肺气肿进展相关的因素知之甚少。本研究旨在探讨戒烟时间长短和临床/人口统计学因素对男性重度吸烟者肺气肿进展和 FEV1 下降率的影响。
3670 名男性吸烟者平均（标准差）吸烟 40.8（17.9）包年，在基线和 1 年及 3 年随访时进行胸部 CT 扫描和肺功能检查。记录吸烟状态（戒烟≥5 年、≥1-<5 年、<1 年或当前吸烟者）。通过方差分析调整年龄、身高、基线肺功能和肺气肿严重程度、吸烟包年数、研究年限和呼吸道症状，评估随访后肺气肿进展率和 FEV1 下降率。以戒烟≥5 年组为参照。
中位数（Q1-Q3）肺气肿严重程度，<-950 HU，为 8.8（5.1-14.1），平均（标准差）FEV1 为 3.4（0.73）L 或 98.5（18.5）%预计值。戒烟>5 年组与当前吸烟者相比，肺气肿进展速度明显较慢，分别为每年 1.07%和 1.12%（p<0.001）。当前吸烟者的 FEV1 年下降量为 69ml，而戒烟>5 年的受试者的 FEV1 年下降量为 57.5ml（p<0.001）。
戒烟>5 年可显著减缓肺气肿进展和肺功能下降速度。
在 http://www.trialregister.nl 注册，注册号 ISRCTN63545820。
