摘要

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年期间的支气管反应性、基线FEV1和身高校正FEV1 (delta FEV1/ht3)的年下降之间的关系。临床诊断为哮喘或接受支气管扩张剂治疗的男性被排除在外。支气管反应性测定为吸入组胺激发浓度(PC20)足以使FEV1降低20%;受试者分为反应器(PC20小于或等于16 mg/ml)和非反应器(PC20大于16 mg/ml)。30%的吸烟者，24%的戒烟者和5%的非吸烟者是反应堆。当将使用反应器的吸烟者与未使用反应器的吸烟者进行比较时，反应器显示出1981-2年预测的基线FEV1百分比较低(85% v 108%)，且δ FEV1/ht3较快(14.1 v 9.2 ml/y/m3)。吸烟者(rs = 0.51)和戒烟者(rs = 0.61)的基线FEV1与PC20相关，所有15名FEV1低于预测值80%的受试者均为反应器。在有吸烟者中，反应堆和非反应堆的δ FEV1/ht3相似(m9.0 v 7.4 ml/y/m3)，尽管基线FEV1有显著差异。当分析局限于基线FEV1超过80%预测的男性时，与不吸烟者相比，吸烟者中反应堆的患病率显著增加，而在已戒烟者中略有增加，尽管平均FEV1在不吸烟者中更高。35岁以下吸烟者的支气管反应性没有增加。 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.