Department of Pulmonary Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, People's Republic of China.
Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2024 Jun 14;19:1315-1331. doi: 10.2147/COPD.S455323. eCollection 2024.
Cigarette smoking is the most recognized risk factor of chronic obstructive pulmonary disease (COPD) in China. However, there are no studies analyzing the impact of different smoking behaviors on pulmonary function and pulmonary hypertension (PH) among Chinese male patients with COPD.
Chinese male smokers with COPD performed pulmonary function tests. Clinical characteristics, smoking behavior features, spirometry and echocardiographic results were compared between the two groups stratified by initial smoking age (18 years old) or complicated PH.
The early-smoking group had more respiratory symptoms, more severe smoking behavior, worse pulmonary function with lower FEV1%pre (38.5% vs 70.2%) and FEV1/FVC% (47.5% vs 63.8%), and higher systolic pulmonary artery pressure (sPAP: 38.6 vs 33.9 mmHg) than the late-smoking group. Initiating smoking before adulthood was an independently contributing factor of ventilatory dysfunction and Global Initiative for Obstructive Lung Disease (GOLD) stage escalation. It also had a significant interaction with long smoking duration (≥30 years), characterized by markedly decreased lung volumes (VC%pre: 64.0% vs 84.5%), impaired diffusing capacity (DLCO%pre: 58.0% vs 76.8%) and severe emphysema (RV/TLC%pre: 145.2% vs 130.2%). COPD patients complicated with PH exhibited worse ventilatory function (FEV1%pre: 43.2% vs 56.2%), impaired diffusion capacity (DLCO%pre: 56.7% vs 77.1%) and decreased lung volume (VC%pre: 67.67% vs 75.38%). Both severe smoking behaviors and impaired pulmonary function had close correlations with sPAP.
The early-smoking group exhibited predominantly ventilation dysfunction and had complex interactions with long smoking duration to further affect lung volume and diffusion capacity. Different smoking behaviors influenced variations of pulmonary dysfunction and comorbid PH in patients with COPD.
在中国，吸烟是慢性阻塞性肺疾病（COPD）最公认的危险因素。然而，目前尚无研究分析不同吸烟行为对中国男性 COPD 患者肺功能和肺动脉高压（PH）的影响。
对中国男性吸烟 COPD 患者进行肺功能检查。根据初始吸烟年龄（18 岁）或并发 PH，将患者分为两组，比较两组间的临床特征、吸烟行为特征、肺功能和超声心动图结果。
早吸烟组的呼吸道症状更明显，吸烟行为更严重，肺功能更差，FEV1%pre（38.5%比 70.2%）和 FEV1/FVC%（47.5%比 63.8%）更低，收缩期肺动脉压（sPAP：38.6 比 33.9mmHg）更高。成年前开始吸烟是通气功能障碍和全球倡议对阻塞性肺疾病（GOLD）阶段升级的独立危险因素。它与长期吸烟（≥30 年）有显著的相互作用，表现为肺容积明显减少（VC%pre：64.0%比 84.5%），弥散能力受损（DLCO%pre：58.0%比 76.8%）和严重肺气肿（RV/TLC%pre：145.2%比 130.2%）。并发 PH 的 COPD 患者通气功能更差（FEV1%pre：43.2%比 56.2%），弥散能力受损（DLCO%pre：56.7%比 77.1%），肺容积减少（VC%pre：67.67%比 75.38%）。严重的吸烟行为和受损的肺功能与 sPAP 密切相关。
早吸烟组主要表现为通气功能障碍，与长期吸烟相互作用，进一步影响肺容积和弥散能力。不同的吸烟行为影响 COPD 患者的肺功能障碍和并发 PH 的变化。
