Lower respiratory illnesses promote FEV1 decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease -: Results from the Lung Health Study
Lower respiratory illnesses promote FEV1 decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease -: Results from the Lung Health Study
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DOI：
10.1164/ajrccm.164.3.2010017
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发表时间：
2001-08-01
影响因子：
24.7
通讯作者：
Connett, JE
中科院分区：
文献类型：
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作者：
Kanner, RE;Anthonisen, NR;Connett, JE
我们分析了肺健康研究（LHS）的数据，以评估自我报告的下呼吸道疾病导致的医生就诊（LRI）对肺功能的影响。参与者为5,887名年龄在35-60岁之间的吸烟者，FEV1/FVC < 0.70， FEV1预测值为55-90%。三分之二的人被随机分为强化戒烟计划（SI）；三分之一的人只被建议戒烟。对于5年的参与者，每年进行肺活量测定并询问有关LRI的问题。SI组的戒烟率高于常规护理组（UC），且LRI较低（p = 0.0008）。持续戒烟者的LRI低于持续吸烟者（p = 0.0003）。在发生LRI的那一年，持续戒烟者的FEV1没有变化，但吸烟者的FEV1显著下降（p = 0.0001），如果没有发生LRI，则在第二年有所恢复。超过5年，LRI仅对吸烟者的FEV1下降率有显著影响。在5年内平均1 LRI/年的吸烟者中，FEV1的额外下降为7 ml/年（p = 0.001）。超过1个LRI/年的吸烟者下降幅度更大。慢性支气管炎与LRI频率增加有关，但不影响其对肺功能的影响。在轻度COPD患者中，吸烟和LRI对FEV1有交互作用，而在吸烟者中，频繁的LRI可能影响疾病的长期病程。
We analyzed Lung Health Study (LHS) data to assess the effect of self-reported lower respiratory illnesses resulting in physician visits (LRI) on lung function. Participants were 5,887 smokers aged 35-60 yr, FEV1/FVC < 0.70 and FEV1 of 55-90% predicted. Two-thirds were randomized into an intensive smoking cessation program (SI); one-third were advised only to stop smoking (UC). For 5 yr participants had annual spirometry and questioning regarding LRI. SI had greater rates of smoking cessation than usual care (UC) with fewer LRI (p = 0.0008). Sustained quitters had fewer LRI than continuing smokers (p = 0.0003). In the year LRI occurred, FEV1 did not change in sustained quitters, but decreased significantly in smokers (p = 0.0001) with some recovery the following year if no LRI occurred. Over 5 yr, LRI had a significant effect on rate of decline of FEV1 only in smokers. In smokers averaging one LRI/yr over 5 yr there were additional declines in FEV1 of 7 ml/yr (p = 0.001). Smokers with more than one LRI/yr had greater declines. Chronic bronchitis was associated with increased frequencies of LRI, but did not affect their influence on lung function. Smoking and LRI had an interactive effect on FEV1, in people with mild COPD, and in smokers frequent LRI may influence the longterm course of the disease.