Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease - The Lung Health Study
Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease - The Lung Health Study
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DOI：
10.1164/ajrccm.161.2.9901044
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发表时间：
2000-02-01
影响因子：
24.7
通讯作者：
Tashkin, DP
中科院分区：
文献类型：
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作者：
Scanlon, PD;Connett, JE;Tashkin, DP
以前关于戒烟对肺功能的研究没有充分量化戒烟的长期益处，也没有建立气道高反应性等特征的预测价值。在北美10个医学中心进行的一项前瞻性随机临床试验中，我们研究了3，926名患有轻度至中度气道阻塞的吸烟者（3，818名具有可分析的结果;入组时平均年龄为48.5岁; 36%为女性），随机分为两个戒烟组之一或非干预组。我们每年测量一次肺功能，持续5年。戒烟的参与者在戒烟后的一年中经历了FEV 1的改善（平均47 ml或2%）。持续戒烟者随后的FEV 1下降率是持续吸烟者的一半，分别为31 +/- 48和62 +/- 55 ml（平均值+/- SD），与从不吸烟者相当。肺功能变化的预测因素包括对β受体激动剂的反应性、基线FEV 1、乙酰甲胆碱反应性、年龄、性别、种族和基线吸烟率。呼吸系统症状不能预测肺功能的变化。有气流阻塞的吸烟者，尽管以前有大量吸烟史、高龄、基线肺功能差或气道高反应性，但戒烟仍能获益。
Previous studies of lung function in relation to smoking cessation have not adequately quantified the long-term benefit of smoking cessation, nor established the predictive value of characteristics such as airway hyperresponsiveness. In a prospective randomized clinical trial at 10 North American medical centers, we studied 3,926 smokers with mild-to-moderate airway obstruction (3,818 with analyzable results; mean age at entry, 48.5 yr; 36% women) randomized to one of two smoking cessation groups or to a nonintervention group. We measured lung function annually for 5 yr. Participants who stopped smoking experienced an improvement in FEV1 in the year after quitting (an average of 47 ml or 2%). The subsequent rate of decline in FEV1 among sustained quitters was half the rate among continuing smokers, 31 +/- 48 versus 62 +/- 55 ml (mean +/- SD), comparable to that of never-smokers. Predictors of change in lung function included responsiveness to beta-agonist, baseline FEV1, methacholine reactivity, age, sex, race, and baseline smoking rate. Respiratory symptoms were not predictive of changes in lung function. Smokers with airflow obstruction benefit from quitting despite previous heavy smoking, advanced age, poor baseline lung function, or airway hyperresponsiveness.