关键词: airway hyperresponsiveness asthma lung function pack-year smoking young patients

Mesh : Adult Age of Onset Anti-Asthmatic Agents / therapeutic use Asthma / drug therapy physiopathology Bronchodilator Agents / therapeutic use Cigarette Smoking / physiopathology Cross-Sectional Studies Female Forced Expiratory Volume / physiology Humans Japan Male Peak Expiratory Flow Rate / physiology Respiratory Hypersensitivity / physiopathology Retrospective Studies Risk Factors Tertiary Care Centers Time Factors Vital Capacity / physiology Young Adult

来  源:   DOI:10.1136/bmjopen-2018-023450   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
In daily clinical practice, smokers with asthma and with intermittent disease severity are frequently encountered. The effects of short-term smoking on lung function or disease presentation in younger patients with intermittent adult-onset asthma remain unclear. We sought to clarify the effects of short-term smoking (<10 pack-years) on lung function and airway hyper-responsiveness (AHR) in young patients with untreated intermittent adult-onset asthma.
Retrospective, cross-sectional study.
A single primary-tertiary medical centre in Japan.
From patients who underwent bronchodilator reversibility tests between January 2004 and March 2011 (n=7291), 262 consecutive patients (age, 20-34 years) with untreated intermittent adult-onset asthma, including 157 never smokers and 105 current smokers within 10 pack-years, were analysed.
The primary outcome was the association of the daily smoking frequency (number of cigarettes per day), smoking duration (years) and cumulative smoking history (pack-years) with postbronchodilator lung function. The secondary outcome was the association of the former three smoking parameters with AHR.
The daily smoking frequency, smoking duration and cumulative smoking history were significantly associated with decreased postbronchodilator lung function. Daily smoking of ≥11 cigarettes per day was also associated with marked AHR (OR 2.23; 95% CI 1.03 to 4.80), even after adjustment for age, sex, disease duration and body mass index.
Short-term active smoking in early adulthood may be associated with decreased lung function and AHR, even in patients with intermittent adult-onset asthma. Our findings suggest a benefit of never smoking, even for young patients with intermittent adult-onset asthma.
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