Siekmeier R, Schiller-Scotland C F, Stahlhofen W
Zentrum für Innere Medizin, J. W. Goethe Universität, Frankfurt, Germany.
Toxicol Lett. 1996 Nov;88(1-3):263-70. doi: 10.1016/0378-4274(96)03748-4.
Chronic cigarette consumption is a generally accepted reason for the development of chronic obstructive pulmonary disease (COPD). COPD correlates to histomorphological parameters of lung structure as well as pulmonary function tests (PFT). COPD related changes affect PFT determined by conventional methods (bodyplethysmography, spirometry) as well as parameters of convective gas mixing. This study evaluates the diagnostic potential of a non-invasive aerosol method for the discrimination between healthy smokers and nonsmokers in comparison to conventional PFT. The aerosol method is based on the inhalation of small aerosol pulses suspended in particle free air and determines their changes during the breathing maneuver. Changes of aerosol pulse parameters (APP) are used to describe the convective component of gas mixing during ventilation. PFT and APP were determined in 40 healthy subjects (nonsmoker: 51.1 +/- 1.5 years; smoker: 49.6 +/- 1.5 years, 39.1 +/- 2.2 pack years) before and after a time interval of 30 months. Conventional PFT in smokers and nonsmokers showed no relevant differences between the values at the beginning and the end of the observation period. Thirty months later, at the end of the observation interval, a very similar behavior of the APP was obtained, which strongly confirmed the prior observed differences between smokers and nonsmokers. The data suggest that cigarette smoke-induced variations of lung function are also detectable in clinically asymptomatic smokers. Even in cases of normal PFT, most APP are able to discriminate between healthy smokers and nonsmokers. Since PFT showed only minor differences between both groups, it is indicated that APP are superior to PFT in the detection of early disturbances of lung ventilation in healthy smokers. Mean values of PFT and APP in smokers and nonsmokers showed a high reproducibility of the data obtained at the beginning of the study as well as at the end of the observation period. The data of our study further confirm that parameters of pulmonary gas exchange and gas mixing are affected by cigarette smoke at an earlier time than parameters of breathing mechanics.
长期吸烟是慢性阻塞性肺疾病（COPD）发展的一个普遍公认的原因。COPD与肺结构的组织形态学参数以及肺功能测试（PFT）相关。COPD相关变化会影响通过传统方法（体容积描记法、肺量计）测定的PFT以及对流气体混合参数。本研究评估了一种非侵入性气溶胶方法与传统PFT相比，在区分健康吸烟者和非吸烟者方面的诊断潜力。该气溶胶方法基于吸入悬浮在无颗粒空气中的小气溶胶脉冲，并确定其在呼吸动作过程中的变化。气溶胶脉冲参数（APP）的变化用于描述通气过程中气体混合的对流成分。在40名健康受试者（非吸烟者：51.1±1.5岁；吸烟者：49.6±1.5岁，39.1±2.2包年）中，在30个月的时间间隔前后测定了PFT和APP。吸烟者和非吸烟者的传统PFT在观察期开始和结束时的值之间没有显著差异。30个月后，在观察期结束时，获得了APP非常相似的行为，这有力地证实了之前观察到的吸烟者和非吸烟者之间的差异。数据表明，在临床上无症状的吸烟者中也可检测到香烟烟雾引起的肺功能变化。即使在PFT正常的情况下，大多数APP也能够区分健康吸烟者和非吸烟者。由于两组之间PFT仅显示出微小差异，表明在检测健康吸烟者肺通气的早期干扰方面，APP优于PFT。吸烟者和非吸烟者的PFT和APP平均值显示，在研究开始时以及观察期结束时获得的数据具有很高的可重复性。我们研究的数据进一步证实，肺气体交换和气体混合参数比呼吸力学参数更早受到香烟烟雾的影响。
