矽肺患者血清克拉拉细胞蛋白和表面活性蛋白D的改变

Changes of Clara cell protein and surfactant protein-D in serum of patients with silicosis

目的 探讨矽肺患者血清克拉拉细胞蛋白（CC16）和表面活性蛋白D（SP-D）的改变。方法 以无接尘史健康体检者为对照组，按接尘史及X线胸片改变确定矽尘接触组、0组、Ⅰ期矽肺组，每组30人，采静脉血5ml，以ELISA法检测血清中CC16和SP-D含量并进行分析比较。结果矽尘接触组、0组、Ⅰ期矽肺组血清CC16含量分别为（4．54±2．10）、（3.81±1．87）和（4．04±1．87）ng／ml，明显低于对照组。差异有统计学意义（P〈0．01）；对照组内不吸烟人群的血清CCl6含量高于吸烟人群，差异有统计学意义（P〈0．05），矽尘接触组、0^＋组且、Ⅰ期矽肺组之间血清CCl6含量差异无统计学意义（P〉0．05）。0^＋组、Ⅰ期矽肺组血清SP-D含量分别为（47．41±16．78）和（110．33±54．22）ng／ml，明显高于对照组和矽尘接触组，差异均有统计学意义（P〈0．05或P〈0．01）；Ⅰ期矽肺组血清SP-D含量高于0^＋组，差异有统计学意义（P〈0．01）。以血清CC16和SP-D建立判别分析方程，对对照组、矽尘接触组、Ⅰ期矽肺组的正确判别率分别为86．7％、86．7％、76．7％，总体判别效率为84．2％。结论 长期暴露于矽尘环境下的工人血清CC16含量降低，而SP-D量进行性升高。

bjective To explore the changes of Clara cell protein （CC16） and the surfactant protein-D （SP-D） in the serum of patients with silicosis. Methods The concentrations of CC16 and SP-D were measured in the serum by sandwich enzyme-linked immunosorbent assays. The subjects consisted of 30 healthy volunteers and 90 silica-exposed workers including the silica-exposed group, the silicosis suspects group（0^＋） and the silicosis phase Ⅰ group, 30 subjects each group. Results The concentration of CC16 in the serum was significantly decreased in silica-exposed workers compared with controls （P〈0.01）; The concentration of CC 16 in the serum was higher in lifelong nonsmokers than the current smokers in control subjects （P〈0.05）, but there were no differences between lifelong nonsmokers and current smokers of 90 silica-exposed workers. Compared with control subjects, the levels of SP-D in the serum of silicosis suspects （0^＋） and silicosis phase Ⅰ groups were signiiicantly elevated （P〈0.01, respectively）, which were also higher than the silica-exposed group （P〈0.05 and P〈 0.01, respectively）. Discriminant equations set by CC16 and SP-D were used in diagnosis of silicosis, and the rate of accuracy in healthy volunteers, the silica-exposed group and the silicosis phase I group were 86.7%, 86.7% and 76.7%, respectively. The total rate of correct classification hit 84.2%. Conclusion The serum CC16 of long-term silica-exposed workers is decreased, and SP-D is increased gradually.