Optimal cutoff level of breath carbon monoxide for assessing smoking status in patients with asthma and COPD
Optimal cutoff level of breath carbon monoxide for assessing smoking status in patients with asthma and COPD
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DOI：
10.1378/chest.124.5.1749
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发表时间：
2003-11-01
期刊：
影响因子：
9.6
通讯作者：
Mishima, M
中科院分区：
文献类型：
--
作者：
Sato, S;Nishimura, K;Mishima, M
研究目的：评估呼吸 CO 浓度的最佳临界水平，以区分哮喘和 COPD 患者中实际吸烟者与非吸烟者。地点：京都大学医院门诊部。对象和方法：通过自我报告的吸烟状况、呼吸 CO 监测和血清可替宁浓度对 331 名连续门诊患者（161 名哮喘患者和 170 名慢性阻塞性肺病患者）进行横断面检查。通过血清可替宁浓度验证实际吸烟状况。结果：患有哮喘的从不吸烟者、前吸烟者和当前吸烟者的平均血清可替宁浓度分别为6.0 +/- 5.2 ng/mL、12.1 +/- 25.0 ng/mL和198.3 +/- 181.7 ng/mL (+/- SD)。患有 COPD 的前吸烟者和当前吸烟者的平均血清可替宁浓度分别为 23.2 +/- 69.2 ng/mL 和 191.1 +/- 109.8 ng/mL。患有哮喘的从不吸烟者、曾经吸烟者和当前吸烟者的平均呼吸二氧化碳水平分别为 6.1 +/- 2.4 ppm、7.7 +/- 3.2 ppm 和 19.9 +/- 17.3 ppm。患有 COPD 的前吸烟者和当前吸烟者的平均呼吸 CO 水平分别为 7.7 +/- 4.3 ppm 和 13.5 +/- 6.5 ppm。区分实际吸烟者和非吸烟者的最佳呼吸 CO 临界水平是哮喘患者中的 10 ppm 和 COPD 患者中的 11 ppm，灵敏度分别为 85.0% 和 73.1%，特异性为 85.8% 和 84.7%。结论：评估实际吸烟状况的呼吸 CO 最佳临界水平为稳定型哮喘患者为 10 ppm，稳定期哮喘患者为 11 ppm。慢性阻塞性肺病。在患有哮喘和慢性阻塞性肺病的患者中，呼吸二氧化碳水平可能受到潜在气道炎症的影响，这表明通过呼吸二氧化碳评估吸烟状况的错误分类。
Study objectives: To assess the optimal cutoff level of breath CO concentration to distinguish actual smokers from nonsmokers among patients with asthma and COPD.Setting: Kyoto University Hospital outpatient clinic.Subjects and methods: Three hundred thirty-one consecutive outpatients (161 with asthma and 170 with COPD) were examined cross-sectionally by self-reported smoking status, breath CO monitoring, and serum cotinine concentration. Actual smoking status was verified by serum cotinine concentration.Results: Mean serum cotinine concentrations of never smokers, former smokers, and current smokers with asthma were 6.0 +/- 5.2 ng/mL, 12.1 +/- 25.0 ng/mL, and 198.3 +/- 181.7 ng/mL, respectively (+/- SD). Mean serum cotinine concentrations of former smokers and current smokers with COPD were 23.2 +/- 69.2 ng/mL and 191.1 +/- 109.8 ng/mL, respectively. Mean breath CO levels of never smokers, former smokers, and current smokers with asthma were 6.1 +/- 2.4 ppm, 7.7 +/- 3.2 ppm, and 19.9 +/- 17.3 ppm, respectively. Mean breath CO levels of former smokers and current smokers with COPD were 7.7 +/- 4.3 ppm and 13.5 +/- 6.5 ppm, respectively. The optimal cutoff level of breath CO to discriminate between actual smokers and nonsmokers was 10 ppm in patients with asthma and 11 ppm in patients with COPD, giving 85.0% and 73.1% sensitivity, and 85.8% and 84.7% specificity, respectively.Conclusion: The optimal cutoff level of breath CO to assess actual smoking status was 10 ppm in patients with stable asthma and I I ppm in patients with stable COPD. In patients with asthma and COPD, breath CO levels were potentially influenced by underlying airway inflammation, suggesting misclassification in the assessment of smoking status by breath CO.