空气中SO2,PM2.5浓度水平与居民每日门诊就诊人次的动态研究

通过对１９９５年重庆渝中区空气中ＳＯ２、ＰＭ２．５浓度水平与居民每日就诊人数的动态观察发现：居民内科各月门认及诊人次按病种分类显示，慢性阻塞性肺部疾病（ＣＯＰＤ）在空气ＳＯ２、ＰＭ２．５空气浓度水平出现峰值的一月份呈现高峰；各年龄组四大类疾病的延迟七日的门诊女性就认人次中，ＣＯＰＤ和循环系统疾病的就诊人次与ＳＯ２、ＰＭ２．５浓度相关系数在０．４－０．７之间，有较为密切的关系。ＣＯＰＤ的时间聚集性分     

Assessing Respiratory Morbidity Through Pollution Status and Meteorological Conditions for Delhi

The study focuses on assessing the status of respiratory morbidity in Delhi over a four years period from 2000–2003. An attempt was made to investigate the role of important pollutants (SO₂, NO₂, SPM and RSPM) and various meteorological factors (temperature minimum & maximum, relative humidity at 0830 and 1730 hrs. and wind speed) in being responsible for respiratory admissions on account of COPD, asthma and emphysema. The study showed that winter months had greater exposure risk as pollutants often get trapped in the lower layers of atmosphere resulting in high concentrations. Statistical analysis revealed that two pollutants have significant positive correlation with the number of COPD cases viz., SPM (r = 0.474; p < 0.01) and RSPM (r = 0.353; p < 0.05), while a meteorological factor temperature (minimum) has a significant negative correlation (r = −0.318; p < 0.05) with COPD. Stepwise multiple regression analysis was performed for COPD as dependent variable and R² value of 0.33 was obtained indicating that SPM and RH(1730) were able to explain 33 percent variability in COPD. The partial correlation of SPM and RH(1730) on COPD was higher than any other combination and therefore they can be regarded as important contributing variables on COPD.     

COPD合并Ⅱ型呼吸衰竭患者无创通气的护理体会

探讨COPD合并Ⅱ型呼吸衰竭神志清楚患者无创通气的护理体会.方法:南华大学附属第一医院呼吸内科2009年1月-2012年2月收治的98例COPD合并Ⅱ型呼吸衰竭应用无创正压通气治疗的清醒患者,随机分为护理干预组(观察组)与对照组各49例,其中观察组给予系统的护理干预;对照组仅采取一般护理措施.比较两组患者治疗后呼吸参数.结果:护理干预组的pH、PaO2、SaO2等参数明显高于对照组,而PaCO2明显低于对照组.表1,参5.     

室内空气污染对慢性阻塞性肺部疾病的影响

为了探讨室内空气污染与慢性阻塞性肺部疾病(COPD)的关系,对云南省宣威县使用不同生活燃料、年龄≥40岁的农民10892人进行了COPD及其症状的现患率调查,同时测定了调查对象的最大呼气流速(PEF).结果表明,不同燃料造成的室内空气污染对COPD及其症状和最大呼气流速的作用顺序依次为有烟煤>无烟煤>柴.在调整了年龄、性别、吸烟和改灶年限等因素后发现,使用有烟煤和使用无烟煤的人群患COPD的危险性分别是使用柴的4.63倍和1.55倍.改灶年限越长,COPD及其症状的现患率越低,最大呼气流速越高.室内燃煤空气污染是影响宣威慢性阻塞性肺部疾病(COPD)的主要危险因素,改炉改灶对控制COPD及其症状的现患水平,改善肺功能具有积极的作用.     

可吸入颗粒物在不同阻塞性呼吸道内运动与沉积特性

为弄清颗粒污染物在慢性阻塞性肺病工人呼吸道内运动和沉积规律,采用数值方法讨论了2类阻塞性呼吸道内气固流动特性,分析了阻塞率（α）、阻塞位置、劳动强度等因数对流场分布、颗粒沉积形式和沉积率的影响.结果表明,α越大,病人局部缺氧越严重,当α=0.8时,相对缺氧率可达90%以上;劳动强度越强或受阻塞位置越深,病人发生哮喘的可能性愈高.呼吸道变形不会改变颗粒的沉积机制,但对其沉积形式有显著影响.α增大,劳动强度增强,粒径变大,均会导致颗粒沉积分布不对称性提高,且下呼吸道粒子沉积分布对称性更好.此外,呼吸道变形使总沉降率（η_t）减小,且α越大,η_t越小.发现对于低劳动强度,下呼吸道或者d_p>5μm的大颗粒,α对η_t影响要更为显著.     

气温与臭氧协同作用对COPD住院人数的影响

为评价气温与臭氧（O₃）协同作用对慢性阻塞性肺病（COPD）住院人数的影响,采用广义相加模型（GAM）、平滑曲线阈值效应和饱和效应方法,在控制了时间序列长期趋势、季节效应、节假日效应和相对湿度、污染物PM_2.5、SO₂、NO₂浓度混杂因素的影响后,分析了2013~2016年石家庄市气温与O₃协同作用对COPD住院人数影响的暴露-反应关系,并考虑了不同年龄、性别的分人群效应.结果表明,日平均气温的阈值为0.3,19℃,O₃的分层临界值100μg/m³;当O₃≥100μg/m³时,随着气温每上升1℃,COPD日均住院人数增加的相对危险度1.042（95%：1.020,1.065）,并且在T≥19℃时其效应值最大,为1.084（95%：1.048,1.121）.较高气温、高O₃污染环境对COPD疾病人群的影响存在协同加强效应,且对老年人影响更敏感,而男女性别上没有显著差异.     

PM2.5水溶性和有机组分对肺上皮细胞损伤及COPD相关基因和蛋白表达影响

为了检测大气PM_(2.5)对正常肺上皮细胞(BEAS-2B)的损伤作用和慢性阻塞性肺病(COPD)相关基因及蛋白的表达变化,将PM_(2.5)的不同组分对肺上皮细胞进行染毒24 h后,通过MTT、荧光探针、Western Blot、单细胞凝胶电泳、实时荧光定量PCR、ELISA等方法检测细胞损伤、COPD相关基因和蛋白表达的变化情况.结果发现,PM_(2.5)可造成肺上皮细胞活性降低,且呈剂量依赖性,PM_(2.5)的不同组分对细胞造成的损伤也不同,有机相组分在细胞凋亡、紧密连接蛋白表达量、DNA损伤和炎症反应等方面造成的影响都比水相组分严重,而水相组分在氧化应激反应和COPD相关蛋白变化程度方面的作用都高于有机相组分.由此可见,PM_(2.5)可对肺上皮细胞造成多种不同程度、不同水平的损伤作用,其中,氧化应激可能是影响COPD相关基因和蛋白表达的重要因素.     

Investigating the impact of air pollution on AMI and COPD hospital admissions in the coastal city of Qingdao,China

• The impact of air pollution on AMI/COPD hospital admissions were examined. • Significant connection was found between air pollutants and AMI/COPD in Qingdao. • Nonlinearity exists between air pollution and AMI/COPD hospital admissions. Air pollution has been widely associated with adverse effects on the respiratory and cardiovascular systems. We investigated the relationship between acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD) and air pollution exposure in the coastal city of Qingdao, China. Air pollution in this region is characterized by inland and oceanic transportation sources in addition to local emission. We examined the influence of PM_2.5, PM₁₀, NO₂, SO₂, CO and O₃ concentrations on hospital admissions for AMI and COPD from October 1, 2014, to September 30, 2018, in Qingdao using a Poisson generalized additive model (GAM). We found that PM_2.5, PM₁₀, NO₂, SO₂ and CO exhibited a significant short-term (lag 1 day) association with AMI in the single-pollutant model among older adults (>65 years old) and females, especially during the cold season (October to March). In contrast, only NO₂ and SO₂ had clear cumulative lag associations with COPD admission for females and those over 65 years old at lag 01 and lag 03, respectively. In the two-pollutant model, the exposure-response relationship fitted by the two-pollutant model did not change significantly. Our findings indicated that there is an inflection point between the concentration of certain air pollutants and the hospital admissions of AMI and COPD even under the linear assumption, indicative of the benefits of reducing air pollution vary with pollution levels. This study has important implications for the development of policy for air pollution control in Qingdao and the public health benefits of reducing air pollution levels.     

Erroneous mass transit system and its tended relationship with motor vehicular air pollution (An integrated approach for reduction of urban air pollution in Lahore)

Air pollution is threat to the lives of people living in big cities of Pakistan. In Lahore 1,250 people die annually because of air pollution.Mass transit system that can be put forth as solution to urban air pollution is contingent with right choice of system and its affiliation with motorized vehicles and nature of urban air pollution.Existing mass transit system in Lahore due to untrue operation causes surfeit discharge of motor vehicular carbon monoxide. Tended relationships of mass transit system with motorized vehicles and urban air pollution are quite noteworthy. The growing motor vehicles (a consequence of flawed public mass transit system) are potential source of urban air pollution. This paper attempts to highlight correlations and regression curves of existing mass transit system. Further it recommends a two facet approach for reduction of motor vehicular air pollution in Lahore.     

Minimizing human health effects of urban air pollution through quantification and control of motor vehicular carbon monoxide (CO) in Lahore

Impact of urban air pollution has variety of focuses such as urban ecology, human health, economy, etc. But human health is always given priority. Air pollution is threat to the lives of people living in big cities of Pakistan. In Lahore only there die 1,250 people annually because of air pollution. A strong correlation exists between urban air pollution and human health in Lahore. Growth of COPD is highest among other air pollution borne diseases. Existing mass transit system (one of driving forces behind motor vehicular emission) in Lahore due to frequent stoppages, entering and exit in flow of traffic causes excess discharge of motor vehicular carbon monoxide (CO) which is a hazardous to human health. Quantification and enumeration of this discharge is essential for environmental management. The paper is an attempt to highlight human health effects of urban air pollution through correlation and regression analysis. Further it is focused upon quantifying excess motor vehicular carbon monoxide through application of simplified mobile emission model. In light of results emission control measures are recommended.