Jensen E J, Dahl R, Steffensen F
Dept of Respiratory Diseases, University Hospital of Aarhus, Noerrebrogade, Denmark.
Eur Respir J. 1998 Mar;11(3):670-6.
Bronchial reactivity to cigarette smoke (CBR) in a cross-section of 98 smokers has been investigated. All participants were subjects to skin-prick tests to common allergens, lung function measurements and bronchial challenges with methacholine and cigarette smoke. In 38 participants a rechallenge with cigarettes was performed 1 h after the first cigarette challenge. Lung function indices analysed were: forced expiratory volume in one second (FEV1); maximal expiratory flow at 75% of the forced vital capacity (MEF75%); and forced mid-expiratory flow between 25 and 75% of the forced vital capacity (FEF(25-75%)). All participants were tested for asthma and allergy, and were required to provide information regarding respiratory symptoms, first degree relatives with asthma and allergy and smoking habits. A substantial decrease was seen in all lung function indices after 12 cigarette-smoke inhalations, but only FEV1 was related to other variables. The maximal mean percentage fall in FEV1 was 10%, which was directly related to the number of inhalations (p<0.05). In multiple regression analyses the percentage fall in FEV1 was directly related to: FEV1/vital capacity (VC) (p<0.01); to the asthmatic/bronchitic status (p<0.05); and to the accumulated and standardized cigarette consumption (p<0.05). The percentage fall in FEV1 bore no relationship to methacholine bronchial reactivity, sex or age and had a continuous distribution. The repeat challenge showed a smaller fall in FEV1 compared to the first challenge after 12 cigarette smoke inhalations (p<0.05). The percentage fall in FEV1 correlated after the first and the repeat challenge (p<0.05). Repeatability of the challenge could not be determined in this study because of tachyphylaxis. Bronchial reactivity to cigarette smoke is a tobacco smoke-specific bronchial response. All participants responded and the response showed a continuous distribution. Bronchial reactivity to cigarette smoke may be of importance for symptoms and prognosis in chronic bronchitis and chronic obstructive pulmonary disease and should be studied in relation to the degree of accelerated lung function loss in smokers and other cigarette induced lung abnormalities.
对98名吸烟者进行了横断面研究，以调查支气管对香烟烟雾的反应性（CBR）。所有参与者都接受了针对常见过敏原的皮肤点刺试验、肺功能测量以及用乙酰甲胆碱和香烟烟雾进行的支气管激发试验。在38名参与者中，在第一次香烟激发试验后1小时进行了再次香烟激发试验。分析的肺功能指标包括：一秒用力呼气量（FEV1）；用力肺活量75%时的最大呼气流量（MEF75%）；以及用力肺活量25%至75%之间的用力呼气中期流量（FEF(25 - 75%)）。所有参与者都接受了哮喘和过敏测试，并被要求提供有关呼吸道症状、患有哮喘和过敏的一级亲属以及吸烟习惯的信息。在吸入12次香烟烟雾后，所有肺功能指标均出现显著下降，但只有FEV1与其他变量相关。FEV1的最大平均下降百分比为10%，这与吸入次数直接相关（p<0.05）。在多元回归分析中，FEV1的下降百分比与以下因素直接相关：FEV1/肺活量（VC）（p<0.01）；哮喘/支气管炎状态（p<0.05）；以及累积和标准化的香烟消耗量（p<0.05）。FEV1的下降百分比与乙酰甲胆碱支气管反应性、性别或年龄无关，且呈连续分布。与吸入12次香烟烟雾后的第一次激发试验相比，再次激发试验显示FEV1的下降幅度较小（p<0.05）。第一次和再次激发试验后FEV1的下降百分比具有相关性（p<0.05）。由于快速减敏，本研究无法确定激发试验的可重复性。支气管对香烟烟雾的反应性是一种特定于烟草烟雾的支气管反应。所有参与者均有反应，且反应呈连续分布。支气管对香烟烟雾的反应性可能对慢性支气管炎和慢性阻塞性肺疾病的症状和预后具有重要意义，应结合吸烟者肺功能加速丧失的程度以及其他香烟诱发的肺部异常情况进行研究。
