Ito Juliana T, Ramos Dionei, Lima Fabiano F, Rodrigues Fernanda M M, Gomes Paulo R, Moreira Graciane L, Macchione Mariangela, Toledo Alessandra C, Ramos Ercy M C
Department of Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente.
Clinic of Medical Specialties, a partner of UNESP, Clinical Center, Presidente Prudente.
Respir Care. 2015 Mar;60(3):399-405. doi: 10.4187/respcare.03266. Epub 2014 Nov 11.
Exposure to cigarette smoke causes significant impairment in mucociliary clearance (MCC), which predisposes patients to secretion retention and recurrent airway infections that play a role in exacerbations of COPD. To determine whether smoking cessation may influence MCC and frequency of exacerbations, the following groups were evaluated: ex-smokers with COPD, smokers with COPD, current smokers with normal lung function, and nonsmokers with normal lung function.
Ninety-three subjects were divided into 4 groups: ex-smokers with COPD (n = 23, 62.4 ± 8.0 y, 13 males), smokers with COPD (n = 17, 58.2 ± 8.0 y, 6 males), current smokers (n = 27, 61.5 ± 6.4 y, 17 males), and nonsmokers (n = 26, 60.8 ± 11.3 y, 7 males). MCC was evaluated using the saccharin transit time (STT) test, and the frequency of exacerbations in the last year was assessed by questionnaire. The Kruskal-Wallis test followed by Dunn's test were used to compare STT among groups, and the Goodman test was used to compare the frequency of exacerbations.
STT of smokers with COPD (16.5 [11-28] min; median [interquartile range 25-75%]) and current smokers (15.9 [10-27] min) was longer compared with ex-smokers with COPD (9.7 [6-12] min) and nonsmokers (8 [6-16] min) (P < .001). There was no difference in STT values between smokers with COPD and current smokers, and these values in ex-smokers with COPD were similar to the control group (P > .05). The frequency of exacerbations was lower in ex-smokers with COPD compared with smokers with COPD.
One year after smoking cessation, subjects with COPD had improved mucociliary clearance.
接触香烟烟雾会导致黏液纤毛清除功能（MCC）显著受损，这使患者易出现分泌物潴留和反复的气道感染，而这些在慢性阻塞性肺疾病（COPD）急性加重中起作用。为了确定戒烟是否会影响MCC和急性加重的频率，对以下几组人群进行了评估：患有COPD的戒烟者、患有COPD的吸烟者、肺功能正常的当前吸烟者以及肺功能正常的非吸烟者。
93名受试者被分为4组：患有COPD的戒烟者（n = 23，62.4±8.0岁，13名男性）、患有COPD的吸烟者（n = 17，58.2±8.0岁，6名男性）、当前吸烟者（n = 27，61.5±6.4岁，17名男性）和非吸烟者（n = 26，60.8±11.3岁，7名男性）。使用糖精转运时间（STT）试验评估MCC，并通过问卷调查评估过去一年中急性加重的频率。采用Kruskal-Wallis检验和Dunn检验比较各组间的STT，采用Goodman检验比较急性加重的频率。
与患有COPD的戒烟者（9.7 [6 - 12]分钟）和非吸烟者（8 [6 - 16]分钟）相比，患有COPD的吸烟者（16.5 [11 - 28]分钟；中位数[四分位间距25 - 75%]）和当前吸烟者（15.9 [10 - 27]分钟）的STT更长（P <.001）。患有COPD的吸烟者和当前吸烟者之间的STT值没有差异，患有COPD的戒烟者的这些值与对照组相似（P >.05）。与患有COPD的吸烟者相比，患有COPD的戒烟者急性加重的频率更低。
戒烟一年后，患有COPD的受试者的黏液纤毛清除功能有所改善。
