Gomes R, Luís F, Tavares A, Sousa N, Correia S, Reis M
Pulmonology Service, Sousa Martins Hospital, Local Health Unit, Guarda, Portugal; Faculty of Health Sciences of the University of Beira Interior, Covilhã, Portugal.
Pulmonology Service, Sousa Martins Hospital, Local Health Unit, Guarda, Portugal; Faculty of Health Sciences of the University of Beira Interior, Covilhã, Portugal.
Rev Port Pneumol (2006). 2015 May-Jun;21(3):126-31. doi: 10.1016/j.rppnen.2014.07.007. Epub 2015 Mar 9.
To investigate the respiratory function and lung hyperinflation in asymptomatic smokers without previous pulmonary pathology and with normal chest radiography. To identify tobacco-related diseases and to correlate tobacco consumption, duration of exposure to tobacco smoke and urinary cotinine with the existence of tobacco-related disease.
Case-controlled study with pairing by sex, age, and body mass index.
smokers who presented to the first appointment of smoking cessation at the Hospital Sousa Martins (HSM) without respiratory symptoms and with normal chest radiography. Definition of control: users without current and/or past tobacco exposition and with plethysmography and chest radiography at HSM within normal parameters.
Reductions in FEV1/FVC, FEF 75%, FEF 25-75% and the cardiothoracic index were detected in smokers and showed a moderated inverse correlation of TLC (with statistical meaning) compared with the control group. Approximately 31.2% of the smokers showed extrapulmonary disease related to tobacco, and 9.38% of the smokers exhibited subclinical chronic obstructive pulmonary disease (COPD). Smokers with tobacco-related diseases presented a mean age and RV/TLC ratio superior to smokers without pathology.
The reduction of the mean values of FEV1/FVC, FEF 75%, FEF 25-75% and the cardiothoracic index seems to indicate precocious pulmonary dysfunction. This work aims to reveal the importance of detecting premonitory anomalies of pulmonary disease during the subclinical phase in patients at risk. Smoking must be considered a factor of multisystemic repercussion; thus, intervention opportunities in this particular group must not be wasted. This preliminary study identifies potentially promising variables with the aim of testing the hypothesis that there can be premonitory alterations in COPD, according to its evolution versus reversibility after smoking cessation. This work will be concluded in a future study.
调查既往无肺部病变且胸部X光正常的无症状吸烟者的呼吸功能和肺过度充气情况。识别与烟草相关的疾病，并将烟草消费、接触烟草烟雾的持续时间和尿可替宁与烟草相关疾病的存在进行关联。
采用按性别、年龄和体重指数配对的病例对照研究。
在苏萨·马丁斯医院（HSM）首次就诊时无呼吸道症状且胸部X光正常的吸烟者。对照定义：目前和/或过去未接触烟草且在HSM进行的体积描记法和胸部X光检查在正常参数范围内的使用者。
在吸烟者中检测到FEV1/FVC、FEF 75%、FEF 25 - 75%和心胸指数降低，与对照组相比，TLC呈中度负相关（具有统计学意义）。约31.2%的吸烟者表现出与烟草相关的肺外疾病，9.38%的吸烟者表现出亚临床慢性阻塞性肺疾病（COPD）。患有烟草相关疾病的吸烟者的平均年龄和RV/TLC比值高于无病变的吸烟者。
FEV1/FVC、FEF 75%、FEF 25 - 75%和心胸指数平均值的降低似乎表明存在早期肺功能障碍。这项工作旨在揭示在有风险的患者亚临床阶段检测肺部疾病先兆异常的重要性。必须将吸烟视为一个具有多系统影响的因素；因此，绝不能浪费在这一特定群体中的干预机会。这项初步研究确定了潜在有前景的变量，目的是检验这样一个假设，即根据戒烟后的演变与可逆性，COPD可能存在先兆改变。这项工作将在未来的研究中完成。
