矽肺患者周围血淋巴细胞亚群和肿瘤坏死因子水平分析

Detection of the levels of cellular immunity of peripheal blood in silicosis patients

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)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32例(Ⅰ期16例、Ⅱ期10例、Ⅲ期6例)矽肺患者周围血淋巴细胞亚群,同时应用酶联免疫吸附法(ELISA)的方法检测血清中TNF-α的水平,与24例正常健康人作比较。结果周围血CD3+CD4+T淋巴细胞比例和CD4/CD8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+T淋巴细胞比例明显下降(P<0.05);CD3-CD19+细胞比例矽肺患者组均高于正常对照组(P<0.05),随着矽肺期别升高,CD3-CD19+细胞比例逐渐增加(P<0.05);CD3-CD56+细胞和CD3+CD8+T细胞比例在不同期别矽肺患者组和正常人组间差异均无显著性(P>0.05)。各期矽肺患者周围血TNF-α的水平低于正常对照组(P<0.05),矽肺Ⅱ期和Ⅲ期组低于矽肺Ⅰ期组(P<0.05)。结论矽肺患者周围血细胞免疫功能低下,B细胞介导体液免疫的上调。

Objective To analyze the changes of immune levels in individuals with silicosis by determining the distribution of lymphocyte subsets and TNF-α level in peripheral blood. Methods Values of peripheral blood CD4, CD8, CD19, CD56 and CD4/CD8 were examined in 32 eases of silicosis（ 16 cases at stage Ⅰ , 10 eases at stage Ⅱ , and 6 ease at stage Ⅲ ） and in 24 healthy persons with flow eytometry. The levels of TNF-α were detected by ELISA kit,and they were compared with each other. Results ①The values CD4 ,CD4/CD8 ,CD19 between silicosis and healthy controls were significant （P 〈0. 05）. ②The differences in values of peripheral blood CD4, CD19 among three-stage of silicosis were statistically significant （ P 〈 0. 05 ）. ③ There were no differences of CD56 and CD8 between the individuals with silicosis and healthy controls （ P 〉 0. 05 ）. ④Compared to the controls ,TNF-α level was significantly reduced in the silicosis patients （P 〈 0.05 ）. Conclusion There were a declined level of cellar immunity and a up-regulation of humoral immunity in silicosis patients.