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目的 探讨早期矽肺患者支气管肺泡灌洗液 (BALF)中生物标志物。方法 矽尘作业工人 18人 ,按X线诊断矽肺期别分为 0 +组和Ⅰ期组 ;以健康吸烟农民 7人为对照组。经纤支镜支气管肺泡灌洗收集BALF ,进行细胞学检验 ,用细胞毒性试验测定肿瘤坏死因子 (TNF α)含量 ,酶联免疫吸附法测定其他细胞因子含量。结果 矽肺 0 +组及Ⅰ期组BALF中TNF α含量分别为 (7.2 0±1.87)、(9.2 0± 1.10 )U/ml,明显高于对照组的 (5 .71± 0 .89)U/ml,差异有显著性 (P <0 .0 1) ;矽肺Ⅰ期组TNF α含量明显高于 0 +组 ,差异有显著性 (P <0 .0 5 )。TNF α含量与矽尘接触年限存在剂量 -效应关系 (rs=0 .46 98,P <0 .0 5 )。纤维连接蛋白、肺表面活性蛋白A和前胶原Ⅲ肽与对照比较 ,差异无显著性 (P >0 .0 5 )。结论 BALF中TNF α含量升高可能是早期矽尘危害的效应指标
Objective To investigate the biomarkers in bronchoalveolar lavage fluid (BALF) in patients with early silicosis. Methods Silicone dust workers 18 people, according to X-ray diagnosis of silicosis were divided into 0 + group and Ⅰ group; 7 healthy smoking peasants as control group. BALF was collected by bronchoalveolar lavage with fiberoptic bronchoscopy. Cytological examination was performed. The levels of tumor necrosis factor (TNF) were measured by cytotoxicity assay. The levels of other cytokines were determined by enzyme-linked immunosorbent assay. Results The levels of TNFα in BALF in 0 + group and Ⅰ group were (7.2 ± 1.87) and (9.2 ± 1.10) U / ml, respectively, which were significantly higher than those in control group (5.71 ± 0.89) U / ml, the difference was significant (P <0.01). The level of TNFα in stage Ⅰ silicosis group was significantly higher than that in 0 + group, the difference was significant (P <0.05). There was dose-effect relationship between TNFα content and silica exposure (rs = 0.4698, P <0.05). Fibronectin, pulmonary surfactant protein A and procollagen III peptide had no significant difference compared with the control (P> 0.05). Conclusion The increased level of TNFα in BALF may be an indicator of the early damage of silica dust