停止吸烟能大幅改善肺功能

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【DavidShi译文】患有哮喘的吸烟者停止吸烟后不到2个月，肺功能测试结果提高了15％以上。

美国胸腔协会出版的2006年7月版《美国呼吸道与危重症监护医学杂志》发表了此项研究。

格拉斯哥大学呼吸医学系和免疫学系的医学博士尼尔·C·汤姆森和7位同事一起研究了11位哮喘病患者，这些病人以前一直吸烟，现在已经戒烟6周。研究人员说，戒烟1周后病人的肺功能测试结果已恢复到了“相当可观的程度”。

“停止吸烟后肺功能得到显著改善，”汤姆森博士说。“这证明了吸烟对哮喘病人气管造成的有害影响是可逆的。”

“停止吸烟引起的改善远远超出了高剂量抗炎症类药物，如每日40mg连续服用2周的脱氢皮质醇，在我们目前和此前的研究中，这样的药物治疗不能改善吸烟者的肺功能，”他接着说道。“可能是吸烟引起的急性支气管收缩作用的消除，或者是烟气引起的呼吸道促炎症反应的减退改善了肺功能。”

和吸烟者相比，戒烟者除了改善了肺功能测试结果，痰液中中性白细胞计也下降了。中性白细胞是吞噬细菌和真菌和异物的白细胞。

“据报道，吸烟严重的哮喘病人中性白细胞计数高于非吸烟的哮喘病人，”汤姆森博士说。

文章作者们注意到，在很多发展中国家，超过20％的成年哮喘病人频繁吸烟，因急性哮喘病而去医院急诊的比率特别高。

本研究中吸烟的哮喘病人的年龄跨度为18至60岁，肺功能结果均低于预期水平的85％。他们持续吸烟达10年以上，每天超过10支。吸烟组和戒烟组间没有基本生理特征上的差别。

成功戒烟并完成6周研究的10位试验者中，有5位使用了尼古丁贴剂，1位使用了针灸，4位没有使用辅助方法。研究人员相信，他们的发现突出了成年哮喘病人戒烟的重要性。

来源：美国胸腔协会

【云栈感叹】在当初做硕士论文研究的时候，曾经去过2次北京肿瘤医院。当时很惊讶地发现，肿瘤医院门口的早点摊前居然围着一群大口嚼着油条的医生。巨汗！至于普通医院中，医生们吞云吐雾，也是屡见不鲜啊。呜呼！吾知道之不行矣！

【英文原文】

Quitting smoking improves lung function considerably

For smokers with asthma, quitting smoking can improve lung function test scores by more than 15 percent in less than two months.

The findings appear in the second issue for July 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Neil C. Thomson, M.D., of the Departments of Respiratory Medicine and Immunology at the University of Glasgow, and seven associates studied 11 asthmatics who continued to smoke and 10 who quit for six weeks. After only one week of no cigarettes, the researchers said that the lung function test results of the non-smoking patients had improved to a "considerable degree."

"The improvement in lung function seen after smoking cessation was clinically significant," said Dr. Thomson. "It demonstrates that there is a reversible component to the harmful effects of smoking on the airways in asthma."

"The degree of improvement noted for smoking cessation far exceeds that of high-dose anti-inflammatory treatment, such as oral prednisolone, 40 mg daily for 2 weeks, which had no effect on lung function in smokers in our current study and in our previous work," he continued. "The improvement could be due to the removal of the acute bronchoconstrictor effects of cigarette smoke or a reduction in the proinflammatory effects of cigarette smoke on the airways."

In addition to the improved lung function test scores, the "quit" group also showed a reduction in sputum neutrophil counts when compared to those of smokers. Neutrophils are white blood cells (phagocytes) that engulf bacterial and fungal infections, along with ingesting foreign debris.

"Sputum neutrophil counts are reported to be increased in heavy smokers with asthma compared with nonsmokers with asthma," said Dr. Thomson.

The authors noted that in many developed countries, more than 20 percent of adults with asthma are active smokers, with particularly high rates of acute asthmatics visiting hospital emergency rooms.

The smokers with asthma recruited for this study were aged 18 to 60 and had lung function score results of less than 85 percent of their predicted level. They all had a cigarette history of over 10-pack-years and smoked more than 10 cigarettes a day. The investigators saw no differences in the baseline physiological characteristics between the smoking group and those who quit.

Of the 10 subjects who successfully stopped smoking and completed the six-week study, five used nicotine patches, one employed acupuncture and four quit without any aid. The researchers believe that their findings highlight the importance of smoking cessation for adults with asthma.

Source : American Thoracic Society