Effects of marijuana smoking on pulmonary function and respiratory complications - A systematic review
Effects of marijuana smoking on pulmonary function and respiratory complications - A systematic review
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DOI：
10.1001/archinte.167.3.221
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发表时间：
2007-02-12
影响因子：
--
通讯作者：
Fiellin, David A.
中科院分区：
文献类型：
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作者：
Tetrault, Jeanette M.;Crothers, Kristina;Fiellin, David A.
背景：吸食大麻与肺功能或呼吸系统并发症之间的关系知之甚少；因此，我们对吸食大麻对肺功能和呼吸系统并发症的影响进行了系统回顾。 方法：从1966年1月1日至2005年10月28日期间，根据预先定义的标准从MEDLINE、PsychINFO和EMBASE数据库中选择评估吸食大麻对肺功能和呼吸系统并发症影响的研究。两名独立评审员根据既定标准提取数据并评估研究质量。研究结果的临床适用性和研究方法得到了严格评价。结果：34 篇出版物符合选择标准。如果报告检查了短期吸食大麻与气道反应之间的关联，则该报告被归类为挑战研究；其他报告被归类为长期吸食大麻与肺功能或呼吸系统并发症的研究。 12 项挑战研究中有 11 项发现短期吸食大麻与支气管扩张之间存在关联（例如，1 秒内用力呼气量增加 0.15-0.25 L）。长期吸食大麻与气流阻塞措施之间没有发现一致的关联。所有 14 项评估长期吸食大麻和呼吸道并发症的研究都指出，吸食大麻与咳嗽、痰和喘息等呼吸道症状增加有关（例如，吸食大麻和咳嗽之间的关系，比值比为 2.00；95% 置信区间为 1.32-3.01）。研究的总体质量各不相同（例如，控制混杂因素，包括吸烟）。结论：短期接触大麻与支气管扩张有关。关于长期吸食大麻与气流阻塞措施之间的关联，生理学数据尚无定论。长期吸食大麻与提示阻塞性肺病的呼吸道症状增加有关。
Background: The relationship between marijuana smoking and pulmonary function or respiratory complications is poorly understood; therefore, we conducted a systematic review of the impact of marijuana smoking on pulmonary function and respiratory complications.Methods: Studies that evaluated the effect of marijuana smoking on pulmonary function and respiratory complications were selected from the MEDLINE, PsychINFO, and EMBASE databases according to pre-defined criteria from January 1, 1966, to October 28, 2005. Two independent reviewers extracted data and evaluated study quality based on established criteria. Study results were critically appraised for clinical applicability and research methods.Results: Thirty-four publications met selection criteria. Reports were classified as challenge studies if they examined the association between short-term marijuana use and airway response; other reports were classified as studies of long-term marijuana smoking and pulmonary function or respiratory complications. Eleven of 12 challenge studies found an association between short-term marijuana administration and bronchodilation (eg, increases of 0.15-0.25 L in forced expiratory volume in 1 second). No consistent association was found between long-term marijuana smoking and airflow obstruction measures. All 14 studies that assessed long-term marijuana smoking and respiratory complications noted an association with increased respiratory symptoms, including cough, phlegm, and wheeze (eg, odds ratio, 2.00; 95% confidence interval, 1.32-3.01, for the association between marijuana smoking and cough). Studies were variable in their overall quality (eg, controlling for confounders, including tobacco smoking).Conclusions: Short-term exposure to marijuana is associated with bronchodilation. Physiologic data were inconclusive regarding an association between long-term marijuana smoking and airflow obstruction measures. Long-term marijuana smoking is associated with increased respiratory symptoms suggestive of obstructive lung disease.