【摘要】 目的分析环境空气中PM_2.5短期暴露与未确诊COPD人群肺功能的关联,为该类人群的空气污染防护提供科学依据。方法以肺功能检测筛查的未确诊COPD人群作为受试者;于2018年1、3、8和10月4个时间段,对28名受试者进行了重复测量,包括肺功能检测,及每次测量前5 d的环境PM_2.5质量浓度监测、问卷调查;用混合效应模型,分析PM_2.5与肺功能的关联性。PM_2.5质量浓度对肺功能的影响考虑了滞后效应,按照lag0～lag4滞后日期的浓度代入模型。结果 PM_2.5日均质量浓度最高为250.46μg/m³。单日滞后效应结果显示,FEV₁、MEF₂₅、MEF₅₀和一秒率与PM_2.5的质量浓度在lag1有显著的关联性;PM_2.5质量浓度每升高10μg/m³,FEV₁下降0.05 L,MEF₂₅下降0.03 L/s,MEF₅₀下降0.10 L/s,一秒率下降1.09%;FVC、MEF₇₅和PEF与PM_2.5质量浓度无关联。滑动平均滞后效应结果中,仅MEF₅₀与PM_2.5质量浓度在lag01有一定显著关联性（P<0.1）;PM_2.5质量浓度每升高10μg/m³,MEF₅₀下降0.07 L/s。结论环境空气PM_2.5可以导致未确诊COPD人群肺功能通气功能指标的下降,应注重此类人群重污染天气的防护。空气污染对小气道的影响更值得关注。更多还原

【Abstract】 Objectives To analyze the associations between short-term exposure to ambient PM_2.5 and lung function in undiagnosed COPD population, and to provide a scientific foundation for the protection against air pollution. Methods Subjects were undiagnosed COPD population screened by lung function test. In January, March, August, and October of 2018, 28 subjects were tested repeatedly. For each time, lung function testing, questionnaire survey, and the PM_2.5 mass concentration monitoring for 5 days before each lung function test were conducted. Mixed effect model was used to analyze the associations between PM_2.5 and lung function. The lag effect of PM_2.5 mass concentration on lung function was considered, and the lag0～lag4 PM_2.5 mass concentration was used in the model. Results The maximum daily PM_2.5 mass concentration was 250.46 μg/m³. The result of one-day lag effect showed that FEV₁, MEF₂₅, MEF₅₀, and FEV₁/FVC were significantly associated with the mass concentration of PM_2.5 in lag01. As PM_2.5 mass concentration was increased by 10 μg/m³, FEV₁, MEF₂₅, MEF₅₀, and FEV₁/FVC were decreased by 0.05 L, 0.03 L/s, 0.10 L/s, and 1.09%, respectively. FVC, MEF₇₅, and PEF were not associated with PM_2.5 mass concentration. The moving average lag effect showed that only MEF₅₀ was significantly associated with PM_2.5 mass concentration in lag01（P<0.1）. As PM_2.5 mass was increased by 10 μg/m³, MEF₅₀ was decreased by 0.07 L/s. Conclusions Ambient air PM_2.5 can lead to the decline of pulmonary ventilation function indicators in undiagnosed COPD patients, and it is necessary to pay attention to the protection of this group of people against the heavy pollution weather. The impact of air pollution on small airway deserve more attention.更多还原