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目的通过对煤工尘肺患者血清MCP-1含量、肺通气功能变化的研究,探讨二者间是否具有相关关系。方法选取238名男性工人为研究对象,将其分为3组,病例组98人(X线胸片分期:Ⅰ期60例,Ⅱ/Ⅲ期38例)、接尘组40人(未诊断尘肺的接尘煤工)和健康组100人(非接尘健康工人),用ELISA法检测其血清MCP-1水平,并测定其肺通气功能。结果⑴协方差分析,接尘组和病例组的矿工血清MCP-1水平明显高于健康组(P<0.01),但在病例组中,Ⅱ/Ⅲ期尘肺患者血清MCP-1低于Ⅰ期,差异有统计学意义(P<0.05)。⑵协方差分析,肺通气功能的各项指标随煤工尘肺期别的增加均有下降,FVC、FEV1.0/FVC、FEV1.0及VC在病例组与健康组比较时降低(P<0.05),接尘组与健康组比较时未见统计学差异,而FEF25%在接尘组与健康组比较即有统计学差异(P<0.01)。⑶偏相关分析,血清MCP-1在病例Ⅰ期中与FVC、FEV1.0、FEF25%及FEF50%呈负相关关系(P<0.05),在病例Ⅱ/Ⅲ组中,与FEF25%、FEF50%呈正相关关系(P<0.05)。结论煤工尘肺病早期炎症阶段,血清MCP-1大量产生,随病情进展至纤维化阶段被大量消耗;在肺通气功能中,各项指标均随X线期别的增加而降低,其中小气道损伤最敏感;血清MCP-1变化早于X线胸片,提示其可能成为检测早期煤工尘肺肺损伤的灵敏指标,且与肺通气功能指标有相关关系。
OBJECTIVE: To investigate the relationship between serum MCP-1 levels and pulmonary ventilation in coal workers with pneumoconiosis. Methods A total of 238 male workers were selected as study subjects and divided into three groups, 98 cases (X-ray stage: 60 cases in stage Ⅰ, 38 cases in stage Ⅱ / Ⅲ), 40 cases in dust-collecting group 100 persons in the health group (non-dust health workers). The level of serum MCP-1 was detected by ELISA and the lung ventilation function was measured. Results (1) MCP-1 levels in miners’ serum were significantly higher than those in healthy group (P <0.01) by covariance analysis, dust exposure group and case group. However, serum MCP-1 level in patients with stage Ⅱ / Ⅲ pneumoconiosis was lower than that in stage Ⅰ , The difference was statistically significant (P <0.05). (2) The analysis of covariance and the indexes of pulmonary ventilation decreased with the increase of pneumoconiosis stage of coal workers. The levels of FVC, FEV1.0 / FVC, FEV1.0 and VC decreased in the case group and the healthy group (P <0.05 ), There was no significant difference between the dust collection group and the healthy group, and the FEF25% was statistically significant difference between the dust collection group and the healthy group (P <0.01). (3) Partial correlation analysis showed that there was a negative correlation between serum MCP-1 and FVC, FEV1.0, FEF25% and FEF50% (P <0.05) in caseⅠ, and positively correlated with FEF25% and FEF50% in case Ⅱ / Ⅲ Correlation (P <0.05). Conclusion During the early inflammatory stage of coal worker’s pneumoconiosis, the serum MCP-1 is produced in a large amount, which is consumed intensively as the disease progresses to the stage of fibrosis. In the pulmonary ventilation function, all indexes are decreased with the increase of X-ray period, The change of serum MCP-1 was earlier than that of X-ray, suggesting that it may become a sensitive index to detect lung injury of coal worker’s pneumoconiosis in the early stage and have a correlation with lung ventilation function.