Hernández-Zenteno Rafael de Jesús, Flores-Trujillo Fernando, Vázquez-Cortés Jesús Javier, Monteros-Sánchez Carlos Espinosa de Los, Cosío Manuel G
Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
Hospital Ángeles Lomas, Estado de Mexico, Mexico.
Rev Invest Clin. 2019;71(1):64-69. doi: 10.24875/RIC.18002648.
Non-obstructed ever-smokers, with or without symptoms, have generated a great deal of information recently, but few reviews. Even individuals with normal spirometry can present changes in sputum with inflammatory biomarkers (cellular and molecular) and airways and parenchyma with remodeling; when symptomatic (cough, sputum, wheezing, and dyspnea) exacerbations are frequent affecting the individuals' quality of life, there is an increased use of health resources: more medication, emergency visits, and hospital admissions. Non-obstructed smokers may have exercise limitations, increased lung volumes, low diffusion capacity, air entrapment, peripheral airways obstruction, elevated airways resistance, and abnormal multiple breath nitrogen washout, as well as abnormalities in computed tomography studies, such as airway wall thickening, emphysema, or interstitial lung abnormalities. Quitting smoking comprises a first, inexpensive, and often abandoned intervention to arrest respiratory impairment. It is controversial whether or not this population should be treated with other medications. Further studies should be conducted to elucidate the consequences of follow-up and prognosis in this clinical entity.
近期，无症状或有症状的非阻塞性既往吸烟者已产生了大量信息，但相关综述较少。即使是肺活量测定正常的个体，其痰液中也可能出现炎症生物标志物（细胞和分子水平）的变化，气道和实质组织也可能出现重塑；当出现症状（咳嗽、咳痰、喘息和呼吸困难）且频繁发作影响个体生活质量时，医疗资源的使用会增加：更多的药物治疗、急诊就诊和住院治疗。非阻塞性吸烟者可能存在运动受限、肺容积增加、弥散能力降低、气体潴留、外周气道阻塞、气道阻力升高以及多次呼吸氮洗脱异常，同时在计算机断层扫描研究中也可能出现异常，如气道壁增厚、肺气肿或间质性肺异常。戒烟是阻止呼吸功能损害的首要、低成本且常被忽视的干预措施。对于这一人群是否应使用其他药物治疗存在争议。应开展进一步研究以阐明该临床实体的随访结果和预后情况。
