德州城区特征肺部疾病与大气污染的相关性研究
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摘要
肺部疾病的范围很广,包括慢性呼吸道疾病以及肺本身的疾病肺炎;传染性肺部疾病包括慢性的肺结核和急性的SARS。被漠视的肺部疾病已成为导致人类死亡最主要的疾病之一。在中国城市中,呼吸系统疾病已经成为继恶性肿瘤、脑血管病、心脏病后的第四大致死原因,占13%;在农村,慢阻肺则是首位致死因素,占60%。
大气污染是引起肺部疾病的重要原因之一。随着肺部疾病发病率的增长,大气污染与肺部疾病之间相关性的研究越来越引起人们的重视。近年来,国内外不同地区的专业人士,从不同角度,对肺部疾病与大气污染的相关性作了大量的研究,为肺部疾病的诊断、预防和治疗等进行了许多有益的探索。
本文在前人研究的基础上,首先探索了德州城区大气污染特点及其发展变化趋势:从年、季、日,全面总结分析了德州市城区大气污染物的变化规律,并剖析阐述了城区大气污染物的各种影响因素。其次,探索了德州城区肺部疾病特点及其发展变化趋势:通过统计分析,总结出德州市城区特征肺部疾病,并按年、季、日对城区特征肺部疾病的发展变化进行了详细分析。并结合城区大气污染特点及其发展变化趋势,分析了德州城区肺部疾病与大气污染的相关性。
在验证前人研究结果的的基础上,本文分析、明确了德州城区特征肺部疾病的特征大气污染因子,通过分析特征大气污染因子的污染特征和污染来源,明确德州城区特征肺部疾病的大气污染源头因素。从而为德州城区特征肺部疾病控制措施的制定提供切实可靠的依据。
研究结果表明:德州城区特征肺部疾病为慢阻肺、哮喘、肺结核。慢阻肺特征大气污染因子依次是PM_(10)、NO_2;哮喘的特征大气污染因子依次是NO_2、PM_(10);肺结核特征大气污染因子是PM_(10)。从而可确定:从大气污染的角度来讲,慢阻肺主要是由道路扬尘、建筑扬尘、煤烟尘、土壤风沙尘、机动车尾气尘等尘污染源引起的,其次是机动车外排尾气;哮喘主要是由机动车外排尾气引起的,其次是尘污染源;肺结核主要是由尘污染源引起的。
The pulmonary disease encompasses a wide range, including chronic respiratory diseases and pneumonia; chronic infectious disease including tuberculosis and severe acute respirarory syndrome (SARS). These neglected diseases have become the most important diseases to result in death. In the cities of China, respiratory diseases have become the fourth-largest cause to death after malignant neoplasms, cerebrovascular disease, heart disease, accounting for 13%; in rural areas, chronic obstructive pulmonary disease is the primary lethal factor, accounting for 60%.
Atmospheric pollution is one of the important reasons to pulmonary diseases. With the increase of incidence of pulmonary diseases, research about the relationship of air pollution and pulmonary diseases has attracted more and more attention. In recent years, domestic and foreign professionals have done a lot about the correlation of air pollution and pulmonary diseases from different aspects. At the same time, lots of significant exploration about lung disease diagnosis, prevention and treatment has been done.
In this paper, based on previous studies, the characteristics of atmospheric pollution in Dezhou and the trend are studied, including analyzing the changes of atmospheric pollutants of Dezhou in different years, seasons and days, and discussing various influencing factors of the atmosphere pollutants in the city. Then, the auther explores the characteristics of lung disease in Dezhou City and its trends—summarizing characteristic lung disease in Dezhou City by statistical analysis and analyzing the changes of characteristic lung disease in urban areas of Dezhou in years, seasons and days. Combined with the characteristics of urban atmospheric pollution and its development trends, we analysis of the correlation of lung disease and atmospheric pollution in urban area of Dezhou, Finally, on the basis of the analysis in this paper, the author identified the characteristic air pollution factors which caused the characteristic lung disease in Dezhou. By analyzing the characteristic factors and diseases, this paper makeas clear the atmosphere sources of characteristic lung disease in Dezhou City, and provides effective and reliable information to develop control measures of the regional pulmonary disease in Dezhou City.
The results show that: the characteristic pulmonary disease of Dezhou City include the COPD lung disease, asthma and tuberculosis. The characteristic air pollution factors of chronic obstructive pulmonary disease are PM_(10), NO_2; the characteristic air pollution factors of asthma are NO_2, PM_(10); tuberculosis' characteristic air pollution factor is PM_(10). So,from the respect of air pollution, chronic obstructive pulmonary disease is mainly caused by road dust, construction dust, coal dust and soil wind dust; vehicle exhaust dust pollution caused by dust sources, etc., followed by motor vehicle exhaust efflux; asthma mainly from motor vehicle exhaust gas caused by efflux, followed by dust pollution; TB is mainly caused by dust pollution.
大气污染是引起肺部疾病的重要原因之一。随着肺部疾病发病率的增长,大气污染与肺部疾病之间相关性的研究越来越引起人们的重视。近年来,国内外不同地区的专业人士,从不同角度,对肺部疾病与大气污染的相关性作了大量的研究,为肺部疾病的诊断、预防和治疗等进行了许多有益的探索。
本文在前人研究的基础上,首先探索了德州城区大气污染特点及其发展变化趋势:从年、季、日,全面总结分析了德州市城区大气污染物的变化规律,并剖析阐述了城区大气污染物的各种影响因素。其次,探索了德州城区肺部疾病特点及其发展变化趋势:通过统计分析,总结出德州市城区特征肺部疾病,并按年、季、日对城区特征肺部疾病的发展变化进行了详细分析。并结合城区大气污染特点及其发展变化趋势,分析了德州城区肺部疾病与大气污染的相关性。
在验证前人研究结果的的基础上,本文分析、明确了德州城区特征肺部疾病的特征大气污染因子,通过分析特征大气污染因子的污染特征和污染来源,明确德州城区特征肺部疾病的大气污染源头因素。从而为德州城区特征肺部疾病控制措施的制定提供切实可靠的依据。
研究结果表明:德州城区特征肺部疾病为慢阻肺、哮喘、肺结核。慢阻肺特征大气污染因子依次是PM_(10)、NO_2;哮喘的特征大气污染因子依次是NO_2、PM_(10);肺结核特征大气污染因子是PM_(10)。从而可确定:从大气污染的角度来讲,慢阻肺主要是由道路扬尘、建筑扬尘、煤烟尘、土壤风沙尘、机动车尾气尘等尘污染源引起的,其次是机动车外排尾气;哮喘主要是由机动车外排尾气引起的,其次是尘污染源;肺结核主要是由尘污染源引起的。
The pulmonary disease encompasses a wide range, including chronic respiratory diseases and pneumonia; chronic infectious disease including tuberculosis and severe acute respirarory syndrome (SARS). These neglected diseases have become the most important diseases to result in death. In the cities of China, respiratory diseases have become the fourth-largest cause to death after malignant neoplasms, cerebrovascular disease, heart disease, accounting for 13%; in rural areas, chronic obstructive pulmonary disease is the primary lethal factor, accounting for 60%.
Atmospheric pollution is one of the important reasons to pulmonary diseases. With the increase of incidence of pulmonary diseases, research about the relationship of air pollution and pulmonary diseases has attracted more and more attention. In recent years, domestic and foreign professionals have done a lot about the correlation of air pollution and pulmonary diseases from different aspects. At the same time, lots of significant exploration about lung disease diagnosis, prevention and treatment has been done.
In this paper, based on previous studies, the characteristics of atmospheric pollution in Dezhou and the trend are studied, including analyzing the changes of atmospheric pollutants of Dezhou in different years, seasons and days, and discussing various influencing factors of the atmosphere pollutants in the city. Then, the auther explores the characteristics of lung disease in Dezhou City and its trends—summarizing characteristic lung disease in Dezhou City by statistical analysis and analyzing the changes of characteristic lung disease in urban areas of Dezhou in years, seasons and days. Combined with the characteristics of urban atmospheric pollution and its development trends, we analysis of the correlation of lung disease and atmospheric pollution in urban area of Dezhou, Finally, on the basis of the analysis in this paper, the author identified the characteristic air pollution factors which caused the characteristic lung disease in Dezhou. By analyzing the characteristic factors and diseases, this paper makeas clear the atmosphere sources of characteristic lung disease in Dezhou City, and provides effective and reliable information to develop control measures of the regional pulmonary disease in Dezhou City.
The results show that: the characteristic pulmonary disease of Dezhou City include the COPD lung disease, asthma and tuberculosis. The characteristic air pollution factors of chronic obstructive pulmonary disease are PM_(10), NO_2; the characteristic air pollution factors of asthma are NO_2, PM_(10); tuberculosis' characteristic air pollution factor is PM_(10). So,from the respect of air pollution, chronic obstructive pulmonary disease is mainly caused by road dust, construction dust, coal dust and soil wind dust; vehicle exhaust dust pollution caused by dust sources, etc., followed by motor vehicle exhaust efflux; asthma mainly from motor vehicle exhaust gas caused by efflux, followed by dust pollution; TB is mainly caused by dust pollution.
引文
[1]刘义梅.肺性疾病的观察与护理.医学信息,2008,21(2):290-291.
[2]阚海东,陈秉衡.我国部分城市大气污染对健康影响的研究10年回顾.中华预防医学杂志,2002,36(1):59-61.
[3]王瑾,陈秉衡.室内外空气污染对儿童免疫指标的影响.环境与健康杂志,1989,6(4):1-4.
[4]张晓明,裴秀坤.空气污染流行病学研究.环境与健康杂志,2000,17(1):9-12.
[5]田裘学,周伶芝.兰州市大气污染对居民健康影响的研究.中国环境科学,1994,14(3):201-205.
[6]金银龙,赵宝新.中国煤烟型大气污染对人群健康危害的定量研究.环境污染及其防治,2002,31(5):342-348.
[7]金银龙,纪建光.煤烟型大气污染对成人呼吸系统疾病及其症状影响的研究.卫生研究,2001,30(4):241-243,246.
[8]刘凡,洪燕峰.代表性燃煤污染物人群历史暴露浓度数学模型研究.我国煤烟型大气污染对人群健康危害的定量研究论文集,2000.
[9 何兴舟,杨儒道.室内燃煤空气污染与肺癌.昆明:云南科技出版社,1994.197.
[10]刘凡.我国煤烟型大气污染对人群健康危害的定量研究论文集,2000年(3).
[11]井立滨,王淑凡.本溪市大气污染与死亡率的关系.中国公共卫生,1999,15(3):211-212.
[12]孔玲莉,何庆慈等.学龄儿童肺功能的影响因素分析.中国环境监测,2001,17(T01):91-98.
[13]席淑华,孙文娟.大气污染对儿童健康所致潜在危害研究.环境与健康杂志,2000,17(1):26-28.
[14]Arden Pope,George Thurston.Journal of the American Medical Association.2005,23,3456-3459.
[15] Lindner H, Koch J, Niemax K. Production of ultrafine particles by nanosecond laser sampling using orthogonal prepulse laser breakdown. Anal Chem, 2005, 77(23):7528-7533.
[16] Colvin VL. The potential environmental impact of engineered nanomaterials. Nature Biotechol, 2003, 21: 1166-1170.
[17] Proffitt F. Yellow light for nanotech. Science, 2004, 305(5685): 762 [18] Service RF. Nanotoxicology: Nanotechnology grows up. Science, 2004, 304(5678): 1732-1734.
[19] Shekunov B. Nanoparticle technology for drug delivery: From nanoparticles to cutting-edge delivery strategies. IDrugs, 2005, 8(5): 399-403.
[20] Dupont LJ, Rochette F, Demedts MG, Verleden GM. Exhaled nitric oxide correlates with airway hyperresponsiveness in steroid-naive patients with mild asthma. Am J Respir Crit Care Med, 1998, 157: 894-898.
[21] Salome CM, Roberts AM, Brown NJ. Exhaled nitric oxide measurements in a population sample of young adults. Am J Respir Crit Care Med, 1999, 159: 911-916.
[22] Choi J, Hoffman L.A, Rodway G.W, Sethi J.M. Markers of lung disease in exhaled breath:nitric ox-ide .Biol Res Nurs, 2006, 7:241-255.
[23] Markus Battaglia, Heiner bucher, Matthias Egger, Fritz Grossenbacher, Christoph Minder, Daniel Pewsner. The Bayes Library of Diagnostic Studies and Reviews. 2002.
[24] Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
[25] Zamora J, Abraira V, Muriel A, Khan KS, Coomarasamy A. Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol, 2006, 6: 31.
[26] Chatkin J M, Ansarin K, Silroff P E, et al.. Exhaled nitric oxide as anoninvasives assessment of chronic cough. Am J Respir Crit CareMed, 1999, 159: 1810-1813.
[27] Franklin PJ,Turner SW, Le Sou, et al. Exhaled nitric oxide and asthma: complex interactions between atopy,airway responsiveness,and symptoms in a community population of children .Thorax, 2003, 58: 1048-1052.
[28] Makker H. K., Holgate S. T. Relation of the hypertonic saline responsiveness of the air-ways to exercise induced asthma symptom severity and to histamine or methacholine reactivity. Thorax, 1993,48: 142-147.
[29] Arden Pope, George Thurston, et al. An exercise challenge protocol for epidemiological studies of asthma in children: comparison with histamine challenge. EurRespirJ,2002,7(1):43.
[30] Blomberg, et al. The measurement of exhalednitric oxide, a new tool in the management of asthma .Presse Med, 2004, 33: 1451-1458.
[31] van Vliet. Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory oxide and nasal nitric oxide. Am J Respir Crit Care Med, 2005,171:912-930.
[32] Nitta Strategy for Asthma Management and Prevention:GlobalInitiative For Asthma(GINA) .http://www.ginasthma.org. 2006.
[33] Arora R, Thornblade CE, Dauby PA, et al. Exhaled nitric oxidelevels in military recruits with new onset asthma. Allergy AsthmaProc, 2006, 27:493-498.
[34] Miedinger D,Chhajed PN,Tamm M,et al. Diagnostic Tests forAsthma in Firefighters. Chest, 2007,131: 1760-1767.
[35] Heffler E, Guida G, Marsico P, et al. Exhaled nitric oxide as adiagnostic test for asthma in rhinitic patients with asthmaticsymptoms. Respir Med, 2006, 100:1981-1987.
[36] Edwards J, et al. The relationship of exhalednitric oxide to airway inflammation and responsiveness in children. Asthma, 2005, 42: 291-295.
[37] Pekkanen, et al. Hypertonic saline challenge in an epidemiologic survey of asthma in children. Am J Respir CritCare Med, 1994, 150: 1632-1639.
[38]Rao.Repeatability of response tohypertonic saline aerosol in human with mild to severe asthma.Pediatr Pulmonol,1994,(18):330-336.
[39]Borgia P.Bronchial inhalation challengewith ultrasonically nebulized saline;comparison to exercise-inducedasthma.Ann Allergy,1986,57:355-358.
[40]Steenland,et al.Public-health impact of outdoor and traffic-related air pollution:a European assessment.Lancet,2000,356:795-801.
[41]周燕荣,徐放.重庆地区大气污染与住院病人动态的相关性分析.现代预防医学,1997,24(1):43-45.
[42]胡雁.青岛市大气污染对人体健康经济损失评估.中国公共卫生,2003,19(8):940-941.
[43]贾凤芝.机动车尾气对人体的危害及治理对策.今日科苑,2007(7):86-87.
[44]白晓龙,何康林.浅谈汽车尾气与人体健康.环境科学与管理,2006,31(3):64-66.
[45]黄琼中,黄景义.汽车尾气的危害及其治理措施.西藏科技,2005,(6):38-39.
[46]江智勇.汽车尾气的危害及防治.中国现代医药科技,2004,4(4):65-65.
[47]崔九思.大气污染监测方法(第2版).化学工业出版社,1997.1235-1235.
[48]郝吉明,马广大.大气污染控制工程.北京:高等教育出版社,2006.
[49]环境空气质量标准[GB3095-1996].国家环境保护局,1996.
[50]2008年度德州市环境质量报告书.德州市环境保护局
[51]陆培廉.预防医学.北京:人民卫生出版社,1999.7-11.
[52]陈树林,王国林,高俊英,王洪涛.中西医结合治疗慢性支气管炎45例临床观察.牡丹江医学院学报,1988,(04)
[53]崔小群.肺气肿患者的自我护理.当代护士,2005,(01):29-30.
[54]陈海.慢性阻塞性肺病已成“第四杀手”.健康大视野,2003,(01):61-61.
[55]Alan Kaplan,李井泉.慢性阻塞性肺病.中国全科医学,2005,8(02):117-118.
[56]Tiotropium可改善轻度慢性阻塞性肺病患者的肺功能.药学进展,2006,30(10):447-447.
[57]张奇元.慢性阻塞性肺病如何防治.长寿,1999,(11):6-6.
[58]辛桂英,张昆华,周玲业.慢性阻塞性肺病的护理.云南医药,1995,16(02):142-142.
[59]张克显.慢性阻塞性肺病合并类Addison现象1例.中国综合临床,1997,13(04):385-385.
[60]沈贻谔,李守义.上海市区中老年人慢性阻塞性肺病的危险因素分析.中国公共卫生学报,1993,12(6):360-362.
[61]王余民.中西医结合治疗慢性阻塞性肺病30例临床观察.中国中医急症,2005,14(11):1028-1029.
[62]卞慧敏,刘林林.健康人和慢性阻塞性肺病患者呼吸肌耐力测定.医师进修杂志,1993,16(12):8-10.
[63]李建民.慢性肺原性心脏病135例临床分析.西南国防医药,2007,17(02)
[64]胡静,顾顺华,涂静.肺炎39例临床分析.重庆医学,2007,39(07):639-640.
[65]向瑾,钟兴美,刘建华,周娟.肺浓肿的早期治疗56例疗效观察.现代临床医学,2005,31(04):227-228.
[66]韦彩云.复治肺结核的原因及护理对策.广西医科大学学报,2001,(S1):31-32.
[67]杨国儒,张绍坤,王国锋,段胜利,李新.对复治肺结核患者的规范化治疗和个体化治疗的几点思考.中华结核和呼吸杂志,2004,27(02):78-79.
[68]胡兴怀,陈雅娟.氧氟沙星治疗复治肺结核21例分析.中国防痨杂志,1994,(04):154-154.
[69]宋林,何慧能.复治肺结核136例临床分析.成都医药,2003,(04):210-210.
[70]李辉,孙秀玲.复治肺结核成因分析.临床肺科杂志,2002,7(03):63-63.
[71]李新,王国兴.谈对复治肺结核患者进行规范化与个体化治疗的必要性.中华结核和呼吸杂志,2004,72(02):76-77.
[72]郭宝华,张景林.120例复治肺病例结核发生原因分析.中国实用医药,2007,2(06):17-17.
[73]黄团新.复治肺结核68例效果分析(摘要).武警医学,1995,(03)
[74]殷海昌.一阵秋风起几多哮喘声.家庭医药,2003,(11):53-53.
[75]哮喘研究何去何从.中国呼吸与危重监护杂志,2005,4(02):84-85.
[76]袁孝宾,曹金凤.哮喘的前景.国外医学.呼吸系统分册,1998,18(01):17-17.
[77]高菊.哮喘缘何难治愈.国际医药卫生导报,2000,(07):21-21.
[78]金殿春.哮喘辨治举隅.江苏中医药,2005,26(01):21-22.
[79]孙丽英.哮喘溯源.中医药学报,1995,(05):10-10
[80]“烧心”可能是某些哮喘的原因.山东中医杂志,1996,(02)
[81]布老.支气管扩张病理研究.心理与健康,1999,(05)
[82]张梅,迟洪华,刘妙玲.呼吸衰竭的特征.河北职工医学院学报,2000,17(01):69-70.
[83]2004年度德州市环境质量报告书.德州市环境保护局
[84]2005年度德州市环境质量报告书.德州市环境保护局
[85]2006年度德州市环境质量报告书.德州市环境保护局
[86]2007年度德州市环境质量报告书.德州市环境保护局
[87]2008年度德州市环境质量报告书.德州市环境保护局
[2]阚海东,陈秉衡.我国部分城市大气污染对健康影响的研究10年回顾.中华预防医学杂志,2002,36(1):59-61.
[3]王瑾,陈秉衡.室内外空气污染对儿童免疫指标的影响.环境与健康杂志,1989,6(4):1-4.
[4]张晓明,裴秀坤.空气污染流行病学研究.环境与健康杂志,2000,17(1):9-12.
[5]田裘学,周伶芝.兰州市大气污染对居民健康影响的研究.中国环境科学,1994,14(3):201-205.
[6]金银龙,赵宝新.中国煤烟型大气污染对人群健康危害的定量研究.环境污染及其防治,2002,31(5):342-348.
[7]金银龙,纪建光.煤烟型大气污染对成人呼吸系统疾病及其症状影响的研究.卫生研究,2001,30(4):241-243,246.
[8]刘凡,洪燕峰.代表性燃煤污染物人群历史暴露浓度数学模型研究.我国煤烟型大气污染对人群健康危害的定量研究论文集,2000.
[9 何兴舟,杨儒道.室内燃煤空气污染与肺癌.昆明:云南科技出版社,1994.197.
[10]刘凡.我国煤烟型大气污染对人群健康危害的定量研究论文集,2000年(3).
[11]井立滨,王淑凡.本溪市大气污染与死亡率的关系.中国公共卫生,1999,15(3):211-212.
[12]孔玲莉,何庆慈等.学龄儿童肺功能的影响因素分析.中国环境监测,2001,17(T01):91-98.
[13]席淑华,孙文娟.大气污染对儿童健康所致潜在危害研究.环境与健康杂志,2000,17(1):26-28.
[14]Arden Pope,George Thurston.Journal of the American Medical Association.2005,23,3456-3459.
[15] Lindner H, Koch J, Niemax K. Production of ultrafine particles by nanosecond laser sampling using orthogonal prepulse laser breakdown. Anal Chem, 2005, 77(23):7528-7533.
[16] Colvin VL. The potential environmental impact of engineered nanomaterials. Nature Biotechol, 2003, 21: 1166-1170.
[17] Proffitt F. Yellow light for nanotech. Science, 2004, 305(5685): 762 [18] Service RF. Nanotoxicology: Nanotechnology grows up. Science, 2004, 304(5678): 1732-1734.
[19] Shekunov B. Nanoparticle technology for drug delivery: From nanoparticles to cutting-edge delivery strategies. IDrugs, 2005, 8(5): 399-403.
[20] Dupont LJ, Rochette F, Demedts MG, Verleden GM. Exhaled nitric oxide correlates with airway hyperresponsiveness in steroid-naive patients with mild asthma. Am J Respir Crit Care Med, 1998, 157: 894-898.
[21] Salome CM, Roberts AM, Brown NJ. Exhaled nitric oxide measurements in a population sample of young adults. Am J Respir Crit Care Med, 1999, 159: 911-916.
[22] Choi J, Hoffman L.A, Rodway G.W, Sethi J.M. Markers of lung disease in exhaled breath:nitric ox-ide .Biol Res Nurs, 2006, 7:241-255.
[23] Markus Battaglia, Heiner bucher, Matthias Egger, Fritz Grossenbacher, Christoph Minder, Daniel Pewsner. The Bayes Library of Diagnostic Studies and Reviews. 2002.
[24] Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
[25] Zamora J, Abraira V, Muriel A, Khan KS, Coomarasamy A. Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol, 2006, 6: 31.
[26] Chatkin J M, Ansarin K, Silroff P E, et al.. Exhaled nitric oxide as anoninvasives assessment of chronic cough. Am J Respir Crit CareMed, 1999, 159: 1810-1813.
[27] Franklin PJ,Turner SW, Le Sou, et al. Exhaled nitric oxide and asthma: complex interactions between atopy,airway responsiveness,and symptoms in a community population of children .Thorax, 2003, 58: 1048-1052.
[28] Makker H. K., Holgate S. T. Relation of the hypertonic saline responsiveness of the air-ways to exercise induced asthma symptom severity and to histamine or methacholine reactivity. Thorax, 1993,48: 142-147.
[29] Arden Pope, George Thurston, et al. An exercise challenge protocol for epidemiological studies of asthma in children: comparison with histamine challenge. EurRespirJ,2002,7(1):43.
[30] Blomberg, et al. The measurement of exhalednitric oxide, a new tool in the management of asthma .Presse Med, 2004, 33: 1451-1458.
[31] van Vliet. Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory oxide and nasal nitric oxide. Am J Respir Crit Care Med, 2005,171:912-930.
[32] Nitta Strategy for Asthma Management and Prevention:GlobalInitiative For Asthma(GINA) .http://www.ginasthma.org. 2006.
[33] Arora R, Thornblade CE, Dauby PA, et al. Exhaled nitric oxidelevels in military recruits with new onset asthma. Allergy AsthmaProc, 2006, 27:493-498.
[34] Miedinger D,Chhajed PN,Tamm M,et al. Diagnostic Tests forAsthma in Firefighters. Chest, 2007,131: 1760-1767.
[35] Heffler E, Guida G, Marsico P, et al. Exhaled nitric oxide as adiagnostic test for asthma in rhinitic patients with asthmaticsymptoms. Respir Med, 2006, 100:1981-1987.
[36] Edwards J, et al. The relationship of exhalednitric oxide to airway inflammation and responsiveness in children. Asthma, 2005, 42: 291-295.
[37] Pekkanen, et al. Hypertonic saline challenge in an epidemiologic survey of asthma in children. Am J Respir CritCare Med, 1994, 150: 1632-1639.
[38]Rao.Repeatability of response tohypertonic saline aerosol in human with mild to severe asthma.Pediatr Pulmonol,1994,(18):330-336.
[39]Borgia P.Bronchial inhalation challengewith ultrasonically nebulized saline;comparison to exercise-inducedasthma.Ann Allergy,1986,57:355-358.
[40]Steenland,et al.Public-health impact of outdoor and traffic-related air pollution:a European assessment.Lancet,2000,356:795-801.
[41]周燕荣,徐放.重庆地区大气污染与住院病人动态的相关性分析.现代预防医学,1997,24(1):43-45.
[42]胡雁.青岛市大气污染对人体健康经济损失评估.中国公共卫生,2003,19(8):940-941.
[43]贾凤芝.机动车尾气对人体的危害及治理对策.今日科苑,2007(7):86-87.
[44]白晓龙,何康林.浅谈汽车尾气与人体健康.环境科学与管理,2006,31(3):64-66.
[45]黄琼中,黄景义.汽车尾气的危害及其治理措施.西藏科技,2005,(6):38-39.
[46]江智勇.汽车尾气的危害及防治.中国现代医药科技,2004,4(4):65-65.
[47]崔九思.大气污染监测方法(第2版).化学工业出版社,1997.1235-1235.
[48]郝吉明,马广大.大气污染控制工程.北京:高等教育出版社,2006.
[49]环境空气质量标准[GB3095-1996].国家环境保护局,1996.
[50]2008年度德州市环境质量报告书.德州市环境保护局
[51]陆培廉.预防医学.北京:人民卫生出版社,1999.7-11.
[52]陈树林,王国林,高俊英,王洪涛.中西医结合治疗慢性支气管炎45例临床观察.牡丹江医学院学报,1988,(04)
[53]崔小群.肺气肿患者的自我护理.当代护士,2005,(01):29-30.
[54]陈海.慢性阻塞性肺病已成“第四杀手”.健康大视野,2003,(01):61-61.
[55]Alan Kaplan,李井泉.慢性阻塞性肺病.中国全科医学,2005,8(02):117-118.
[56]Tiotropium可改善轻度慢性阻塞性肺病患者的肺功能.药学进展,2006,30(10):447-447.
[57]张奇元.慢性阻塞性肺病如何防治.长寿,1999,(11):6-6.
[58]辛桂英,张昆华,周玲业.慢性阻塞性肺病的护理.云南医药,1995,16(02):142-142.
[59]张克显.慢性阻塞性肺病合并类Addison现象1例.中国综合临床,1997,13(04):385-385.
[60]沈贻谔,李守义.上海市区中老年人慢性阻塞性肺病的危险因素分析.中国公共卫生学报,1993,12(6):360-362.
[61]王余民.中西医结合治疗慢性阻塞性肺病30例临床观察.中国中医急症,2005,14(11):1028-1029.
[62]卞慧敏,刘林林.健康人和慢性阻塞性肺病患者呼吸肌耐力测定.医师进修杂志,1993,16(12):8-10.
[63]李建民.慢性肺原性心脏病135例临床分析.西南国防医药,2007,17(02)
[64]胡静,顾顺华,涂静.肺炎39例临床分析.重庆医学,2007,39(07):639-640.
[65]向瑾,钟兴美,刘建华,周娟.肺浓肿的早期治疗56例疗效观察.现代临床医学,2005,31(04):227-228.
[66]韦彩云.复治肺结核的原因及护理对策.广西医科大学学报,2001,(S1):31-32.
[67]杨国儒,张绍坤,王国锋,段胜利,李新.对复治肺结核患者的规范化治疗和个体化治疗的几点思考.中华结核和呼吸杂志,2004,27(02):78-79.
[68]胡兴怀,陈雅娟.氧氟沙星治疗复治肺结核21例分析.中国防痨杂志,1994,(04):154-154.
[69]宋林,何慧能.复治肺结核136例临床分析.成都医药,2003,(04):210-210.
[70]李辉,孙秀玲.复治肺结核成因分析.临床肺科杂志,2002,7(03):63-63.
[71]李新,王国兴.谈对复治肺结核患者进行规范化与个体化治疗的必要性.中华结核和呼吸杂志,2004,72(02):76-77.
[72]郭宝华,张景林.120例复治肺病例结核发生原因分析.中国实用医药,2007,2(06):17-17.
[73]黄团新.复治肺结核68例效果分析(摘要).武警医学,1995,(03)
[74]殷海昌.一阵秋风起几多哮喘声.家庭医药,2003,(11):53-53.
[75]哮喘研究何去何从.中国呼吸与危重监护杂志,2005,4(02):84-85.
[76]袁孝宾,曹金凤.哮喘的前景.国外医学.呼吸系统分册,1998,18(01):17-17.
[77]高菊.哮喘缘何难治愈.国际医药卫生导报,2000,(07):21-21.
[78]金殿春.哮喘辨治举隅.江苏中医药,2005,26(01):21-22.
[79]孙丽英.哮喘溯源.中医药学报,1995,(05):10-10
[80]“烧心”可能是某些哮喘的原因.山东中医杂志,1996,(02)
[81]布老.支气管扩张病理研究.心理与健康,1999,(05)
[82]张梅,迟洪华,刘妙玲.呼吸衰竭的特征.河北职工医学院学报,2000,17(01):69-70.
[83]2004年度德州市环境质量报告书.德州市环境保护局
[84]2005年度德州市环境质量报告书.德州市环境保护局
[85]2006年度德州市环境质量报告书.德州市环境保护局
[86]2007年度德州市环境质量报告书.德州市环境保护局
[87]2008年度德州市环境质量报告书.德州市环境保护局