Bronchial reactivity to inhaled histamine and annual rate of decline in FEV1 in male smokers and ex-smokers.
Bronchial reactivity to inhaled histamine and annual rate of decline in FEV1 in male smokers and ex-smokers.
复制标题
男性吸烟者和戒烟者的支气管对吸入组胺的反应性和 FEV1 年下降率。
作者：
RG Taylor;H. Joyce;BG Simonsson;G. F. Rego;A. R. Rojo
我们研究了227名男性（117名吸烟者，71名戒烟者和39名非吸烟者）在7.5年内支气管反应性、基线FEV 1和身高校正FEV 1年下降率（Δ FEV 1/ht 3）之间的关系。排除临床诊断为哮喘或接受支气管扩张剂治疗的男性。支气管反应性被确定为足以使FEV 1降低20%的吸入组胺的激发浓度（PC 20）;受试者被分为反应者（PC 20小于或等于16 mg/ml）和非反应者（PC 20大于16 mg/ml）。30%的吸烟者、24%的戒烟者和5%的非吸烟者是反应者。当吸烟的反应者与非反应者进行比较时，反应者表现出较低的基线FEV 1（1981-2年预测的百分比）（85% vs 108%），以及较快的Δ FEV 1/ht 3（14.1 vs 9.2 ml/y/m3）。在吸烟者（rs = 0.51）和戒烟者（rs = 0.61）中，基线FEV 1与PC 20相关，所有15例FEV 1低于预测值80%的受试者均为反应者。在既往吸烟者中，反应者和非反应者的Δ FEV 1/ht 3相似（m 9.0 v 7.4 ml/y/m3），尽管基线FEV 1存在显著差异。当分析仅限于基线FEV 1超过80%预测值的男性时，与非吸烟者相比，吸烟者中反应物的患病率显著增加，戒烟者中反应物的患病率略有增加，尽管非吸烟者的平均FEV 1较高。在吸烟者中，有过敏史（通常是过敏性鼻炎）的人的Δ FEV 1/ht 3更快，但与过敏性疾病家族史、总血清免疫球蛋白E水平、绝对血嗜酸性粒细胞计数或皮肤点刺试验评分无关。在所有服用β受体阻滞剂的受试者中，Δ FEV 1/ht 3也更快。因此，吸烟者支气管反应性增加与FEV 1的加速下降有关。尽管这种关联可能是基线FEV 1较低的结果，但在基线FEV 1正常的吸烟者中发现了反应性增加的趋势，并且在既往吸烟者中，Δ FEV 1/ht 3与反应性增加无关。这些发现与“荷兰假说”相一致，但过敏特征与加速Δ FEV 1/ht 3之间的关联相对较弱，反应性增加可能发生在吸烟之后而不是之前。
We examined the relations between bronchial reactivity, baseline FEV1, and annual decline of height corrected FEV1 (delta FEV1/ht3) over 7.5 years in 227 men (117 smokers, 71 ex-smokers, and 39 non-smokers). Men with a clinical diagnosis of asthma or receiving bronchodilator treatment were excluded. Bronchial reactivity was determined as the provocation concentration (PC20) of inhaled histamine sufficient to reduce FEV1 by 20%; subjects were divided into reactors (PC20 less than or equal to 16 mg/ml) and non-reactors (PC20 greater than 16 mg/ml). Thirty per cent of smokers, 24% of ex-smokers, and 5% of non-smokers were reactors. When smokers who were reactors were compared with non-reactors, the reactors showed a lower baseline FEV1 as percentage predicted in 1981-2 (85% v 108%), and a faster delta FEV1/ht3 (14.1 v 9.2 ml/y/m3). Baseline FEV1 correlated with PC20 in both smokers (rs = 0.51) and ex-smokers (rs = 0.61), and all 15 subjects with an FEV1 under 80% of the predicted value were reactors. In ex-smokers delta FEV1/ht3 was similar in reactors and non-reactors (m 9.0 v 7.4 ml/y/m3), despite significant differences in baseline FEV1. When analysis was confined to men with a baseline FEV1 over 80% predicted, the prevalence of reactors was significantly increased among smokers and slightly increased among ex-smokers compared with non-smokers, though the mean FEV1 was higher in the non-smokers. Bronchial reactivity was not increased in smokers aged 35 years or less. In smokers delta FEV1/ht3 was faster in those with a personal history of allergy (usually allergic rhinitis), but was not related to a family history of allergic disease, total serum immunoglobulin E level, absolute blood eosinophil count, or skinprick test score. delta FEV1/ht3 was also faster in all subjects taking beta blocker drugs. Thus increased bronchial reactivity was associated with accelerated decline of FEV1 in smokers. Although the association could be a consequence of a lower lower baseline FEV1, a trend towards increased reactivity was found in smokers with normal baseline FEV1 and delta FEV1/ht3 was dissociated from increased reactivity in ex-smokers. These findings are compatible with the "Dutch hypothesis," but the association between allergic features and accelerated delta FEV1/ht3 was relatively weak, and increased reactivity may follow rather than precede the onset of smoking.
DOI：
10.1164/arrd.1980.122.5.709
发表时间：
2015-05
期刊：
The American review of respiratory disease
影响因子：
--
作者：
B. Burrows;F. Hasan;R. Barbee;M. Halonen;M. Lebowitz
通讯作者：
B. Burrows;F. Hasan;R. Barbee;M. Halonen;M. Lebowitz
影响因子：
9.6
作者：
MASON, GR;USZLER, JM;REID, E
通讯作者：
REID, E