摘要
目的研究肺泡表面活性蛋白(surfactant-associated proteins,SP)D、肺泡表面活性蛋白A(SP-A)在煤工尘肺病(coal worker’s pneumoconiosis,CWP)患者肺泡灌洗液、血清中的表达意义及与肺部炎症相关性。方法选取2016年8月—2019年6月收治的CWP患者88例作为病例组,同矿区具备相同粉尘接触条件的非CWP井下作业工人92例作为对照组。检测两组血清、肺泡灌洗液SP-D、SP-A水平,并分析其对CWP的诊断价值,同时比较不同分期患者血清、肺泡灌洗液SP-D、SP-A、炎性因子[γ干扰素(interferon gamma,IFN-γ)、白细胞介素-10(interleukin-10,IL-10)]水平及二者关联性。结果病例组血清、肺泡灌洗液SP-D分别为(46.24±10.44)μg/ml和(40.26±13.40)μg/ml、SP-A分别为(42.17±7.30)μg/ml和(11.28±3.74)μg/ml,均低于对照组水平[SP-D分别为(57.63±13.69)μg/ml和(94.18±31.35)μg/ml、SP-A分别为(49.55±9.12)μg/ml和(63.75±21.20)μg/ml(P<0.05)];肺泡灌洗液SP-D、SP-A联合诊断AUC(0.901)>肺泡灌洗液SP-D(0.873)>肺泡灌洗液SP-A(0.863)>血清SP-D(0.788)>血清SP-A(0.764);血清、肺泡灌洗液SP-D、SP-A与IFN-γ、IL-10呈负相关(r1=-0.528,r2=-0.410,r3=-0.549,r4=-0.544,P均<0.05)。结论SP-D、SP-A在CWP患者肺泡灌洗液、血清中呈低表达态势,与肺部炎症存在负相关关系,肺泡灌洗液SP-D、SP-A联合有望成为临床鉴别诊断、判断疾病分期、评估肺部炎症程度的重要有效生物标志物。
Objective To study the significance of alveolar surfactant protein D(SP-D)and alveolar surfactant protein A(SP-A)expression in alveolar lavage fluid and serum of patients with coal worker’s pneumoconiosis(CWP)and their correlation with pulmonary inflammation.Methods Eighty-eight CWP patients admitted from August 2016 to June 2019 were selected as the case group,and 92 non-CWP underground workers with the same dust contact condition in the same mining area severed as the control group.The levels of SP-D and SP-A in serum and alveolar lavage fluid were compared between the two groups,and their diagnostic values for CWP were analyzed.At the same time,we compared the levels of SP-D,SP-A,and inflammatory factors(including interferon gamma(IFN-γ)and interleukin-10(IL-10))in serum and alveolar lavage fluid of patients in different stages and correlation of SP-D and SP-A with IFN-γand IL-10.Results The levels of SP-D((46.24±10.44)μg/ml,(40.26±13.40)μg/ml)and SP-A((42.17±7.30)μg/ml,(11.28±3.74)μg/ml)in serum and alveolar lavage fluid in the case group were all lower than those in the control group(the levels of SP-D were(57.63±13.69)μg/ml and(94.18±31.35)μg/ml,repectively;the levels of SP-D were(49.55±9.12)μg/ml and(63.75±21.20)μg/ml,respectively)(all P<0.05).Analysis of receiver operating characteristic(ROC)curve and area under the curve(AUC)showed combined use of SP-D and SP-A in alveolar lavage fluid for the diagnosis(0.901)>SP-D in alveolar lavage fluid(0.873)>SP-A in alveolar lavage fluid(0.863)>SP-D in serum(0.788)>SP-A in serum(0.764).SP-D and SP-A in serum and alveolar lavage fluid were negatively correlated with IFN-γand IL-10(r1=-0.528,r2=-0.410,r3=-0.549,r4=-0.544,all P<0.05).Conclusions SP-D and SP-A are under-expressed in alveolar lavage fluid and serum of CWP patients,and have a negative correlation with pulmonary inflammation.Combined use of SP-D and SP-A in alveolar lavage fluid is expected to become an important and effective biomarker for clinical differential diagnosis,judgment of disease stage,and assessment of pulmonary inflammation.
作者
胡卓君
吕林
沈春鹦
庞波
董明霞
刘丽
刘建红
HU Zhuo-jun;LYU Lin;SHEN Chun-ying;PANG Bo;DONG Ming-xia;LIU Li;LIU Jian-hong(Department of Occupational Diseases,the Second People’s Hospital of Panzhihua City,Panzhihua,Sichuan 617068,China)
出处
《实用预防医学》
CAS
2020年第11期1349-1352,共4页
Practical Preventive Medicine
作者简介
胡卓君(1986-),女,四川盐边县人,本科,主治医师,主要从事职业病防治工作。
