【摘要】 目的探讨冬季室内外PM_2.5污染水平对慢性阻塞性肺疾病（简称慢阻肺）患者呼出气炎症指标的影响。方法以18名某三甲医院诊断的稳定期慢阻肺患者为研究对象,于2014年1月2日—2月18日,对研究对象室内PM_2.5水平进行实时监测,同步收集研究对象居室附近北京市固定监测点PM_2.5、气温和相对湿度数据,并采集研究对象呼出气一氧化氮（e NO）和呼出气硫化氢（e H2S）样品,采用Spearman相关分析和多元线性回归分析探讨室内外PM_2.5对研究对象呼出气指标的影响。结果调查地区冬季室内、外PM_2.5污染水平较高,x±s分别为（94.09±46.87）μg/m3和（119.27±54.78）μg/m3。室外PM_2.5暴露与e NO呈正相关关系（rs=0.311,P<0.05）,PM_2.5每上升1个四分位数间距（74.80μg/m3）,可使e NO增加13.13μg/m3（P<0.05）,控制室外气温和相对湿度后,该相关关系仍然存在。未观察到室内PM_2.5与e NO以及室内、外PM_2.5与e H2S的相关关系。结论本次调查地区的冬季室内、外PM_2.5污染严重,室外PM_2.5可对慢阻肺患者e NO产生影响。更多还原

【Abstract】 Objective To investigate the pollution level of outdoor and indoor PM2.5during winter, and to evaluate its association with exhaled biomarkers of patients with chronic obstructive pulmonary disease. Methods Eighteen patients with doctor-diagnosed chronic obstructive pulmonary disease were recruited and the study was carried out in winter of 2014(Jan.2nd-Feb. 18th). Concentrations of indoor PM2.5were monitored inside subjects’ living rooms. Meanwhile, the daily data of ambient PM2.5, temperature and relative humidity were also collected. Exhaled breath samples were taken and then analyzed for nitric oxide( NO) and hydrogen sulfide( H2S) by trained investigators. Spearman correlation analysis and multiple linear regression were used to estimate the association between outdoor and indoor PM2.5and exhaled biomarkers. Results Concentrations(x±s) of outdoor and indoor PM2.5during winter in the investigated area in Beijing were(94.09±46.87) μg/m3and(119.27 ±54.78) μg/m3, respectively, indicating a relatively high level of pollution. Exposure to outdoor PM2.5was positively related to exhaled NO of patients with doctor-diagnosed chronic obstructive pulmonary disease, and the relationship remained robust after adjustment for ambient temperature and relative humidity that an IQR increment in concentration of outdoor PM2.5corresponded to 13.13 μg/m3 increase of exhaled NO of patients with doctor-diagnosed chronic obstructive pulmonary disease(P <0.05). No relationships between indoor PM2.5and exhaled NO, outdoor or indoor PM2.5and exhaled H2 S were observed.Conclusion Both the outdoor and indoor PM2.5pollution are serious in the investigated area in Beijing. Exposure to outdoor PM2.5may induce inflammation of respiratory system in patients with chronic obstructive pulmonary disease.更多还原