美国伊利诺斯州公共卫生部Jennifer E. Layden等研究人员，近日取得一项研究成果。他们初步报告了与电子烟有关的肺部疾病。相关论文2019年9月6日在线发表在《新英格兰医学杂志》上。

电子烟是一种电池驱动的设备，它可以加热液体并向用户提供雾化产品。与使用电子烟有关的肺部疾病已有报道。2019年7月，美国威斯康辛州卫生服务部和伊利诺伊州公共卫生部收到了与使用电子烟（也称吸蒸汽）有关的肺部疾病的报告，并展开了一项公共卫生调查。

研究将病例患者定义为在症状出现前90天内使用电子烟和相关设备，影像学上有肺部浸润，且疾病不是由其他原因引起的人。使用标准化工具进行病历摘要和病例访谈。53例患者中，83%为男性，平均年龄19岁。绝大多数患者表现为呼吸系统症状(98%)、胃肠道症状(81%)、体质症状(100%)。所有病例的胸部影像学均有双侧浸润。共有94%的患者住院，32%的患者接受了插管和机械通气，并有一例死亡。84%的患者曾在电子烟设备中使用四氢大麻酚产品。

来自伊利诺伊州的症状监测数据显示，2019年6月至8月，与严重呼吸系统疾病相关的月平均就诊率，是2018年同期的两倍。这些患者的临床表现都很相似，虽然使用电子烟会导致哪些伤害尚未确定，但这类疾病代表了一种或多种新的临床综合征。未来还需要进行更多的工作来描述该病的病理生理学特征并确定最终病因。

附：英文原文

Title: Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin — Preliminary Report

Author:Jennifer E. Layden, M.D., Ph.D., Isaac Ghinai, M.B., B.S., Ian Pray, Ph.D., Anne Kimball, M.D., Mark Layer, M.D., Mark Tenforde, M.D., Ph.D., Livia Navon, M.S., Brooke Hoots, Ph.D., Phillip P. Salvatore, Ph.D., Megan Elderbrook, M.P.H., Thomas Haupt, M.S., Jeffrey Kanne, M.D., Megan T. Patel, M.P.H., Lori Saathoff-Huber, M.P.H., Brian A. King, Ph.D., M.P.H., Josh G. Schier, M.D., Christina A. Mikosz, M.D., M.P.H., and Jonathan Meiman, M.D.

Issue&Volume:September 6, 2019

Abstract:

Background

E-cigarettes are battery-operated devices that heat a liquid and deliver an aerosolized product to the user. Pulmonary illnesses related to e-cigarette use have been reported, but no large series has been described. In July 2019, the Wisconsin Department of Health Services and the Illinois Department of Public Health received reports of pulmonary disease associated with the use of e-cigarettes (also called vaping) and launched a coordinated public health investigation.

Methods

We defined case patients as persons who reported use of e-cigarette devices and related products in the 90 days before symptom onset and had pulmonary infiltrates on imaging and whose illnesses were not attributed to other causes. Medical record abstraction and case patient interviews were conducted with the use of standardized tools.

Results

There were 53 case patients, 83% of whom were male; the median age of the patients was 19 years. The majority of patients presented with respiratory symptoms (98%), gastrointestinal symptoms (81%), and constitutional symptoms (100%). All case patients had bilateral infiltrates on chest imaging (which was part of the case definition). A total of 94% of the patients were hospitalized, 32% underwent intubation and mechanical ventilation, and one death was reported. A total of 84% of the patients reported having used tetrahydrocannabinol products in e-cigarette devices, although a wide variety of products and devices was reported. Syndromic surveillance data from Illinois showed that the mean monthly rate of visits related to severe respiratory illness in June through August of 2019 was twice the rate that was observed in the same months in 2018.

Conclusions

Case patients presented with similar clinical characteristics. Although the features of e-cigarette use that were responsible for injury have not been identified, this cluster of illnesses represents an emerging clinical syndrome or syndromes. Additional work is needed to characterize the pathophysiology and to identify the definitive causes.

DOI:10.1056/NEJMoa1911614

Source:https://www.nejm.org/doi/pdf/10.1056/NEJMoa1911614