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目的 探讨煤尘职业接触者和早期煤工尘肺患者支气管肺泡灌洗液 (BALF)中细胞因子含量改变的特点及意义。方法 采煤工 2 3人 ,按X线胸片诊断为煤尘接触组 (接尘组 )、煤工尘肺 0 +和Ⅰ期组 ;健康农民 7人为对照组。经纤支镜做支气管肺泡灌洗 ,收集BALF ,用酶联免疫吸附法 (ELISA)测定肺泡表面活性蛋白 A(SP A)及肿瘤坏死因子 (TNF α)含量。结果 接尘组BALF中SP A含量为 (6 5 2 8.2±1872 .0 )ng/ml,TNF α含量为 (8.2 3± 1.6 1)U/ml,均明显高于对照组 [(10 5 0 .1± 912 .2 )ng/ml及 (5 .17±0 .89)U/ml],差异有显著性 (P <0 .0 1) ;且随煤工尘肺期别进展 ,SP A及TNF α含量降低 ,SP A及TNF α含量变化与煤工尘肺病变严重性之间呈负相关 (前者r =- 0 .6 4,P <0 .0 1;后者r=- 0 .45 ,P <0 .0 5 )。结论 BALF中SP A和TNF α含量升高可能是煤尘接触的效应指标
Objective To investigate the characteristics and significance of changes of cytokines in bronchoalveolar lavage fluid (BALF) in coal dust occupational contact workers and early coal worker pneumoconiosis patients. Methods Twenty-three coal miners were diagnosed as coal dust exposure group (dust collection group) and coal workers’ pneumoconiosis 0 + and Ⅰ group according to X-ray; and 7 healthy peasants as control group. Bronchoalveolar lavage was performed with fiberoptic bronchoscopy, and BALF was collected. The levels of alveolar surfactant protein A (SP A) and tumor necrosis factor (TNF) were measured by enzyme-linked immunosorbent assay (ELISA). Results The level of SP A in BALF was (62 52 ± 1872. 0) ng / ml and that of TNF α was (8.2 3 ± 1.6 1) U / ml in the dust-exposed group, which were significantly higher than those in the control group [ .1 ± 912.2) ng / ml and (5.17 ± 0.89) U / ml, respectively, with significant difference (P <0.01) TNFα content decreased, SP A and TNFα levels and coal workers pneumoconiosis severity was negatively correlated (former r = - 0.64, P <0.01; the latter r = - 0.45, P <0. 05). Conclusion The increase of SP A and TNFα in BALF may be an indicator of the effect of coal dust exposure