San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182, United States.
University of California San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, United States.
Drug Alcohol Depend. 2020 Sep 1;214:108158. doi: 10.1016/j.drugalcdep.2020.108158. Epub 2020 Jul 2.
Pulmonary tissue damage leading to obstructive lung disease (OLD) could result from intravenous administration of insoluble particles found in illicit drugs. This study described the prevalence and identified correlates of OLD among people who inject drugs (PWID).
In 2012-2016, a community-based cohort of PWID who had injected within the past month were enrolled in a study to assess HIV, hepatitis C virus (HCV) andMycobacterium tuberculosis (Mtb) infections and their related risk factors. Data were obtained through face-to-face interviews, serological testing and spirometry. Baseline data were used for a cross-sectional analysis of the prevalence and correlates of OLD, defined as FEV1/FVC < 0.7. Univariate and multivariable logistic regression were used to identify factors associated with OLD.
Among 516 participants who had complete spirometry and interview results, the mean age was 43.3 years, 73.6 % were male, 9.5 % were Black, 91.1 % smoked cigarettes and 18.2 % had OLD. Few (9.6 %) PWID with OLD reported a previous diagnosis of COPD although many (44.7 %) reported related symptoms. Black race (AOR = 2.66, 95 %CI: 1.37, 5.17), pack-years smoked (AOR = 1.06/5 years, 95 %CI: 1.01, 1.12), and duration of injection drug use (AOR = 1.13, 95 %CI: 1.01, 1.27) were independently associated with OLD after controlling for age.
The prevalence of OLD was high in this cohort and associated with Black race and cigarette smoking-known risk factors. In addition, OLD prevalence increased with greater duration of injection drug use, suggesting a link between cumulative exposure to injected insoluble particles and OLD. Further examination of these adulterants and lung pathology are needed.
静脉注射非法药物中存在的不溶性颗粒会导致肺组织损伤，进而引发阻塞性肺病（OLD）。本研究描述了注射吸毒者（PWID）中 OLD 的流行情况，并确定了其相关因素。
在 2012-2016 年，对过去一个月内有过静脉注射史的社区为基础的 PWID 队列进行了一项研究，以评估 HIV、丙型肝炎病毒（HCV）和结核分枝杆菌（Mtb）感染及其相关危险因素。通过面对面访谈、血清学检测和肺活量测定来获取数据。使用基线数据进行了 OLD 的流行情况和相关因素的横断面分析，定义为 FEV1/FVC<0.7。使用单变量和多变量逻辑回归来确定与 OLD 相关的因素。
在 516 名完成肺活量测定和访谈的参与者中，平均年龄为 43.3 岁，73.6%为男性，9.5%为黑人，91.1%吸烟，18.2%有 OLD。尽管许多（44.7%）报告有相关症状，但很少（9.6%）有 OLD 的 PWID 报告曾被诊断为 COPD。黑人种族（AOR=2.66，95%CI：1.37，5.17）、吸烟包年数（AOR=1.06/5 年，95%CI：1.01，1.12）和注射吸毒持续时间（AOR=1.13，95%CI：1.01，1.27）是在控制年龄后与 OLD 独立相关的因素。
在本队列中，OLD 的患病率较高，与黑人种族和吸烟有关，这是已知的危险因素。此外，随着注射吸毒持续时间的增加，OLD 的患病率也随之增加，这表明注射不溶性颗粒的累积暴露与 OLD 之间存在关联。需要进一步研究这些污染物和肺部病理学。
