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目的分析不同期别矽肺患者周围血淋巴细胞亚群和肿瘤坏死因子(TNF-α)、血清可溶性白细胞介素-2受体(sIL-2R)的变化,探讨不同期别矽肺患者免疫水平的差异。方法应用直接免疫荧光-流式细胞技术检测86例矽肺患者(Ⅰ期32例、Ⅱ期30例、Ⅲ期24例)周围血淋巴细胞亚群,同时应用酶联免疫吸附法(ELISA)检测血清中TNF-α和sIL-2R的水平,与30例正常健康人作比较。结果周围血CD3、CD4比例和CD4/CD8水平矽肺患者组低于正常人组(P<0.05),随着矽肺期别的升高,CD3、CD4比例和CD4/CD8下降,但无统计学差异(P>0.05);各期矽肺患者周围血TNF-α、sIL-2R的水平高于正常对照组(P<0.05),随着矽肺期别的升高,sIL-2R明显升高(P<0.05),TNF-α明显下降(P<0.05)。结论矽肺患者周围血细胞免疫功能低下,TNF-α和sIL-2R协同参与矽肺发生和发展过程。
Objective To analyze the changes of peripheral blood lymphocyte subsets, tumor necrosis factor (TNF-α) and serum soluble interleukin-2 receptor (sIL-2R) in patients with different stages of silicosis and to explore the differences in the immune status between silicosis patients . Methods Direct immunofluorescence-flow cytometry was used to detect peripheral blood lymphocyte subsets in 86 patients with silicosis (32 in stage Ⅰ, 30 in stage Ⅱ, 24 in stage Ⅲ), and serum levels of serum were measured by enzyme-linked immunosorbent assay (ELISA) The levels of TNF-α and sIL-2R were compared with those of 30 normal healthy subjects. Results The levels of CD3, CD4 and CD4 / CD8 in peripheral blood of patients with silicosis were significantly lower than those of normal controls (P <0.05). With the increase of silicosis, the ratio of CD3, CD4 and CD4 / CD8 decreased, but there was no significant difference (P> 0.05). The levels of TNF-α and sIL-2R in the peripheral blood of patients with silicosis were significantly higher than those in the normal control group (P <0.05). The levels of sIL-2R were significantly increased with the progression of silicosis (P < 0.05), TNF-αdecreased significantly (P <0.05). Conclusion The peripheral blood cells of patients with silicosis have poor immune function. TNF-α and sIL-2R are involved in the pathogenesis and development of silicosis.