摘要目的 探讨氢气吸入对环卫工人雾霾暴露的肺保护性作用.方法 2016年1—2月选取石家庄市中心城区96名健康不吸烟环卫工人为研究对象,采用随机、对照、双盲的方法,将研究对象分为试验组(50名)及对照组(46名).试验组给予吸入氢氧混合气(67%/33%)治疗,对照组给予吸入氮氧混合气(67%/33%)治疗,1 h/次,1次/d,为期30 d.分别在试验前1天(第0天)、试验开始第8、15及30天留取血样、诱导痰液、测定肺功能及呼出气一氧化氮(FeNO),问卷调查及随访受试对象自觉症状改善情况.结果 (1)第8天试验组FeNO测定值为(16±5)×109,明显低于对照组的(21±14)×109(F=6.94,P<0.05);(2)第8天试验组FEV1占预计值%为(96±13)%,高于对照组的(94±14)%(F=3.96,P<0.05);第30天试验组FEV1占预计值%为(97±14)%,高于对照组的(95±12)%(F=8.5,P<0.05);第15天试验组PEF占预计值%为(73±15)%,高于对照组的(67±18)%(F=8.68,P<0.05);(3)痰上清液中,试验组第8、15、30天基质金属蛋白酶(MMP)-12与超氧化物歧化酶3(SOD3)低于对照组,第15、30天IL-10高于对照组,第30天丙二醛及IL-2低于对照组(均P<0.05).两组痰液中C反应蛋白(CRP)、转化生长因子(TGF)-β1差异无统计学意义(均P>0.05);(4)血清中,试验组第8、15、30天IL-2与SOD3低于对照组,IL-10高于对照组,第30天MMP-12低于对照组(均P<0.05).血清中CRP、TGF-β1、丙二醛各观察点两组比较差异无统计学意义(均P>0.05);(5)试验组结束治疗后咳嗽等呼吸系统症状得到明显改善.结论 氢气吸入治疗有助于降低气道氧化应激损伤相关炎性水平,对全身炎症反应可能也有一定抑制效果,同时能够改善环卫工人咳嗽等呼吸系统症状.

abstractsObjective To study the protective effect of hydrogen inhalation on the lungs of sanitation workers exposed to haze .Methods In this randomized, double-blind, placebo controlled clinical trial, 96 sanitation workers living in Shijiazhuang urban area were recruited during January to February , 2016.All enrolled participants were randomized to 2 groups; the treatment group inhaled H 2:O2 mixture (66.67%:33.33%) 1 hour per day for 30 days, while the control group inhaled N 2 :O2 mixture (66.67%:33.33%) 1 hour per day for 30 days.Respiratory symptoms were evaluated and fractional exhaled nitric oxide(FeNO), biochemical indexes, lung function were measured at baseline (the 0th day) and during treatment ( the 8th day, 15th day, and 30th day ) .Results ( 1 ) The FeNO levels of the treatment group (16 ±5) ×109 were lower than those of the control group (21 ±14) ×109 on 8th day of treatment, with significant difference(F=6.94,P<0.05).(2)The levels of FEV1 were significantly higher in participants from the treatment group as compared to the control group on both 8th [(96 ±13)%vs(94 ± 14)%(F=3.96,P <0.05)] and 30th day [(97 ±14)% vs (95 ±12)%( F =8.5,P <0.05)] of treatment, while PEF was also increased on 15th day [(73 ±15)%vs(67 ±18)%(F=8.68,P<0.05)]. (3) The sputum levels of MMP-12 and SOD3 were consistently lower in the treatment group as compared to the control group at each time point , and the levels of IL-10 were higher in the treatment group as compared to the control group on the 15th and 30th day.MDA and IL-2 levels were lower in the treatment group than in the control group on the 30th day(P<0.05).The sputum levels of CRP and TGF-β1 at each time point were not different between the 2 groups (P>0.05).(4)The serum levels of IL-2 and SOD3 were lower in the treatment group as compared to the control group while IL-10 was higher than in the control group at each time point, and MMP-12 was lower in the treatment group than that in the control group on the 30th day(P<0.05).The relative ratios of CRP, TGF-β1 and MDA in serum at each time point between the 2 groups were not significantly different ( P >0.05 ) .( 5 ) Hydrogen inhalation improved respiratory symptoms such as cough.Conclusions Inhalation of hydrogen gas could alleviate airway inflammation and oxidative stress of sanitation workers exposed to air pollution .There was even a significant inhibitory effect on the level of systemic inflammatory response.Importantly, inhalation of hydrogen could improve respiratory symptoms such as cough.