Long-term follow-up study of the effects of atmospheric fine particles on COPD disease status

doi:10.3877/cma.j.issn.1674-6902.2020.05.010

Abstract

Abstract:

Objective

To investigate the effect of fine particles on the patients with COPD.

Methods

in this study, 100 COPD patients who were diagnosed in our hospital and whose condition was stable were selected. The pulmonary function, inflammatory factor level, oxidative stress index level and heart rate of the subjects were measured four times after follow-up. The effects of atmospheric fine particles on the pulmonary function of COPD patients were analyzed by linear mixed effect model.

Results

after cumulative exposure for 1-7 days, PM2.5 was negatively correlated with FEV₁ in COPD patients. For every increase of IQR concentration in PM2.5, FEV₁ in COPD patients changed -3.05% (95%CI: -5.11%~- 1.05%)~-2.47% (95%CI: -4.26%~-0.78%); There was a negative correlation between PM_2.5 and FEV₁/FVC% of COPD patients. For every increase of IQR concentration in PM_2.5, FEV₁/FVC% of patients changed from -2.57% (95%CI: -4.69%~-1.53%)~-3.39% (95%CI: -4.02%~-0.74%). According to the stratified analysis of the median levels of H S CRP, SOD and MDA in COPD patients, the effect of PM_2.5 on FEV₁ and FEV₁/FVC was stronger in patients with high hs CRP, high SOD and MDA. In hs-CRP patients, the FEV₁ of PM_2.5 increased by -3.35%(95%CI: -6.47%~-0.28%). In the patients with high SOD, the FEV₁ of PM_2.5 increased by -3.76%(95%CI: -7.32%~-0.22%), In hs-CRP patients, FEV₁/FVC of PM_2.5 increased by -3.76%(95%CI: -7.35%~-0.21%). In patients with high MDA, FEV₁/FVC% changed by -0.98%(95%CI: -1.89%~-0.11%) for every increase of IQR concentration in PM_2.5, and FEV₁/FVC% changed by 1.69%(95%CI: -3.01%~-0.17%) for every increase of IQR concentration in patients with high sod;

Conclusion

aerosols can affect the oxidative stress, inflammatory response, cardiovascular system, lung function of COPD patients.

Key words: Fine particles in the atmosphere, Chronic obstructive pulmonary disease

Zhihong Liu, Tali Fu Ai He Titherm·, Lin Niu. Long-term follow-up study of the effects of atmospheric fine particles on COPD disease status[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(05): 628-632.

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References 32

1	崔永奇，郑　宇，张丽妍，等. 非小细胞肺癌脑转移治疗进展[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(6): 780-783.
2	韩璐瑶，吴克坚，高永恒，等. 不同大气污染物对呼吸系统疾病门诊量的影响[J/CD]. 中华肺部疾病杂志(电子版), 2020, 13(2): 229-235.
3	沈赵赟，符胜光，杨爱东，等. 加味千金苇茎汤对大气细颗粒物致肺损伤大鼠肿瘤坏死因子-α和核因子-κB的影响[J]. 中国中医药信息杂志，2018, 25(1): 38-42.
4	Lin H, Liu T, Xiao J, et al. Mortality burden of ambient fine particuiate air poiiution in six Chinese cities：results from the pearl river delta study[J]. Environ Int, 2016, 96(7): 91-97.
5	申芳霞，朱天乐，牛牧童. 大气颗粒物生物化学组分的促炎症效应研究进展[J]. 科学通报，2018, 10: 968-978.
6	邵龙义，王文华，幸娇萍，等. 大气颗粒物理化特征和影响效应的研究进展及展望[J]. 地球科学-中国地质大学学报，2018, 43(5): 1691-1708.
7	Song C, He J, Wu L, et al. Health burden attributable to ambient PM_2.5 in China[J]. Environ Pollut, 2017, 223(3): 575-586.
8	孟　灿，孙成昊，商　磊. PM_(2.5)对慢性阻塞性肺疾病发生发展影响及药物治疗研究进展[J]. 中国公共卫生，2019, 5(2): 34-36.
9	Devries R, Kriebei D, Sama S. Low level air pollution and exacerbation of existing COPD a case crossover anaiysis[J]. Environ Health, 2016, 15(1): 98-103.
10	杨继雷，姚秀叶，袁晓飞，等. 张家口市大气颗粒物PM_2.5，PM₁₀浓度与慢性阻塞性肺疾病住院人次的关系研究[J]. 现代生物医学进展，2018, 18(6): 177-181+210.
11	王凤卓，夏　艺，李　兵. 细颗粒物对呼吸系统损伤的研究进展[J]. 国际呼吸杂志，2018, 38(5): 382-386.
12	王凤燕，王凌伟，杨宇琼，等. 慢性阻塞性肺疾病年度研究进展(2018-2019)[J]. 中华结核和呼吸杂志，2019, 42(11): 858-861.
13	Zhang Y, Lang JL, Cheng S, et al. Chemical composition and sources of PM1 and PM_2.5 in Beijing in autumn[J]. Sci Total Environm, 2018, 630: 72-82.
14	Qingqing He, Huang Bo. Satellite-based mapping of daily high-resolution ground PM_2.5 in China via space-time regression modeling[J]. Remote Sensing of Environment, 2018, DOI: 10.1016/j.rse.2017.12.018
15	Saffari A, Daher N, Shafer MM, et al. Seasonal and spatial variation in dithiothreitol (DTT) activity of quasi-ultrafine particles in the Los Angeles Basin and its association with chemical species[J]. J Environ Sci Health A Tox Hazard Subst Environ Eng, 2014, 49(4): 441-451.
16	任慧清，鲁建江，宁建英，等. 大气中细颗粒物及其铁元素对大鼠肺损伤的影响[J]. 科学技术与工程，2019, 6(24): 56-58.
17	王　芳，王　娟，韩苗苗，等. 大学校园室内PM2.5重金属污染特征及其健康风险评价[J]. 东南大学学报(自然科学版), 2018, 48(5): 955-960.
18	迟　锐，潘　璐，李宏宇，等. 北京住宅中室内外来源PM_2.5对慢性阻塞性肺疾病患者心率及心率变异性的短期影响[J]. 中华预防医学杂志，2019, 53(1): 57-63.
19	Suk JY, Nam LM, Ji HY, et al. Epidemiological study of PM2.5 and risk of COPD-related hospital visits in association with particle constituents in Chuncheon, Korea[J]. International Journal of COPD, 2018, 13: 299-307.
20	李乃健，李　冰，冉丕鑫. 大气颗粒物对肺部微生态的影响及在慢性阻塞性肺疾病发病中的作用[J]. 中国呼吸与危重监护杂志，2018, 17(2): 206-209.
21	Hwang SL, Lin YC, Guo SE, et al. Fine particulate matter on hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in southwestern Taiwan during 2006-2012[J]. Int J Environ Health Res, 2017, 27(2): 95-105.
22	Halonen JI, Lanki T, Yli-Tuomi T, et al. Particulate air pollution and acute cardiorespiratory hospital admissions and mortality among the elderly[J]. Epidemiology, 2009, 20(1): 143-153.
23	Zhao J, Li M, Wang Z, et al. Role of PM2.5 in the development and progression of COPD and its mechanisms[J]. Respiratory Research, 2019, 20(1): DOI: 10.1186/s12931-019-1081-3
24	Kakol M, Sheehan E, Phillips N, et al. Let′s get particulate about matters on COPD-acute exacerbations of COPD in the albuquerque, NM Area in Association to PM2.5[C]//American Thoracic Society 2019 International Conference, 2019：10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A6022.
25	陈亦晨，李小攀，孙良红，等. 大气细颗粒物(PM-(2.5)和PM-(10))与浦东新区居民慢性阻塞性肺疾病死亡的相关性研究[J]. 中国全科医学，2019, 22(12): 1419-1425.
26	邱巧静，顾　芬. 气温及大气颗粒物与慢性阻塞性肺疾病急性加重关系的研究进展[J]. 国际呼吸杂志，2019, 39(7): 538-541.
27	汉　锋，裴　璐，许　群，等. 环境空气PM_2.5短期暴露与未确诊COPD人群肺功能的关联性[J]. 环境卫生学杂志，2019, 9(3): 197-202.
28	傅振利，曹伟涛，彭公永. 大气细颗粒物对慢性阻塞性肺疾病病情影响的研究进展[J]. 中华结核和呼吸杂志，2018, 7(3): 224-227.
29	迟　锐，潘　璐，李宏宇，等. 北京住宅中室内外来源PM_2.5对慢性阻塞性肺疾病患者心率及心率变异性的短期影响[J]. 中华预防医学杂志，2019, 53(1): 57-63.
30	刘英莉，孟春燕，钱庆增，等. 某市秋冬季大气PM_2.5中金属元素的健康风险评价[J]. 环境与职业医学，2018, 35(7): 602-606.
31	袁　红，李　慧，兰智新，等. PM_2.5颗粒与COPD患者氧化应激水平及炎性因子的相关性[J]. 贵州医药，2019, 43(2): 186-188.
32	周天瑜，钟益珏，王云霞，等. 大气颗粒物影响慢性阻塞性肺疾病发生发展的机制[J]. 中华结核和呼吸杂志，2018, 4(8): 640-643.

随访序号	例数	FEV₁(L)		FEV₁/FVC%(%)		hs-CRP(mg/L)		MDA(μmol/L)		SOD(KU/L)
随访序号	例数	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR
1	100	56.42±4.58	23.0	36.01±2.54	15.9	5.63±3.89	1.46	6.50±1.77	1.64	27.34±2.15	10.3
2	100	57.39±4.37	23.0	35.40±2.33	15.3	5.53±2.86	1.39	6.74±1.59	1.70	26.52±3.02	9.6
3	100	55.79±4.75	21.0	33.89±2.56	14.5	5.02±2.14	1.30	6.32±1.42	1.47	25.69±2.53	9.0
4	100	58.11±3.86	25.0	37.02±2.69	16.1	4.89±2.25	1.24	6.03±1.59	1.39	27.04±3.14	10.1

随访序号	例数	FEV₁(L)		FEV₁/FVC%(%)		hs-CRP(mg/L)		MDA(μmol/L)		SOD(KU/L)
随访序号	例数	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR
1	100	56.42±4.58	23.0	36.01±2.54	15.9	5.63±3.89	1.46	6.50±1.77	1.64	27.34±2.15	10.3
2	100	57.39±4.37	23.0	35.40±2.33	15.3	5.53±2.86	1.39	6.74±1.59	1.70	26.52±3.02	9.6
3	100	55.79±4.75	21.0	33.89±2.56	14.5	5.02±2.14	1.30	6.32±1.42	1.47	25.69±2.53	9.0
4	100	58.11±3.86	25.0	37.02±2.69	16.1	4.89±2.25	1.24	6.03±1.59	1.39	27.04±3.14	10.1

随访序号	心率(次/min)		总功率(ms²)		高频功率(ms²)		低频功率(ms²)		SDNN(ms²)		rMSSD(ms)
随访序号	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR
1	75.6±13.5	38.92	1 806.7±563.9	1 438.5	178.5±67.2	115.8	376.4±98.4	206.1	45.6±23.7	30.2	35.6±12.9	23.8
2	74.6±11.7	38.01	1 758.4±542.8	1 401.4	175.6±58.3	110.3	359.1±89.3	193.6	42.1±26.4	28.8	36.7±12.4	24.6
3	76.1±12.4	39.25	1 811.5±538.1	1 450.6	172.9±60.4	106.7	366.7±90.7	197.5	46.7±22.9	31.5	33.2±11.6	22.4
4	73.8±13.2	37.83	1 784.9±521.6	1 422.5	179.5±64.5	118.0	374.5±93.2	203.7	40.9±19.5	27.2	37.9±10.5	25.7

随访序号	心率(次/min)		总功率(ms²)		高频功率(ms²)		低频功率(ms²)		SDNN(ms²)		rMSSD(ms)
随访序号	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR	(±s)	IQR
1	75.6±13.5	38.92	1 806.7±563.9	1 438.5	178.5±67.2	115.8	376.4±98.4	206.1	45.6±23.7	30.2	35.6±12.9	23.8
2	74.6±11.7	38.01	1 758.4±542.8	1 401.4	175.6±58.3	110.3	359.1±89.3	193.6	42.1±26.4	28.8	36.7±12.4	24.6
3	76.1±12.4	39.25	1 811.5±538.1	1 450.6	172.9±60.4	106.7	366.7±90.7	197.5	46.7±22.9	31.5	33.2±11.6	22.4
4	73.8±13.2	37.83	1 784.9±521.6	1 422.5	179.5±64.5	118.0	374.5±93.2	203.7	40.9±19.5	27.2	37.9±10.5	25.7

随访序号	PM_2.5(μg/m³)		气温(℃)		相对湿度(%)
随访序号	(±s)	IQR	(±s)	IQR	(±s)	IQR
1	154.63±105.86	56.39	3.58±4.06	4.69	28.53±12.46	25.48
2	150.38±97.53	54.02	3.02±4.16	4.31	29.85±10.55	25.85
3	158.43±100.46	57.51	3.69±3.93	4.77	26.42±11.41	24.01
4	151.60±99.18	54.76	3.26±4.25	4.43	27.99±10.58	24.59

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