煤工尘肺患者血清可溶性CD40及其配体水平变化研究

Change and significance of soluble CD40 and soluble CD40-ligand levels in serum of coal workers’pneumoconiosis

目的探讨血清可溶性CD40(sCD40)及其配体(sCD40L)水平在煤工尘肺(CWP)中变化及意义。方法采用酶联免疫吸附法检测95例CWP患者(CWP组)、61例健康井下接尘矿工(接尘对照组)及48例非接尘井上健康人员(正常对照组)血清sCD40及sCD40L水平,并根据CWP期别及有无并发症进行分析。结果与正常对照组比较,接尘对照组sCD40L水平降低明显,差异有统计学意义(P<0.05)。Ⅱ期CWP患者血清sCD40水平明显高于Ⅰ期,CWP并发肺结核患者血清sCD40水平明显高于单纯CWP,差异均有统计学意义(P<0.05)。正常对照、接尘对照和CWP组血清sCD40及sCD40L水平均呈正相关(P<0.05)。结论sCD40L在CWP的早期炎症反应中起一定作用;而sCD40则可能预示着CWP的严重程度,两者共同参与CWP的发生发展过程。

Objective To explore the changes and their significance of soluble CD40 （sCD40） and soluble CD40-ligand （sCD40L） levels in serum of coal workers’ pneumoconiosis（CWP）.Methods Serum levels of sCD40 and sCD40L were determined in 95 cases of CWP （CWP group）,61 cases of healthy miner （dust contacted control group） and 48 cases of healthy control working above the well （control group） by a enzyme-linked immunosorbent assay,and were further evaluated according to the stage and complication in CWP group.Results In comparison with the control group,serum levels of sCD40L in dust contacted control group were significantly lower （P0.05）,but serum levels of sCD40 and sCD40L in CWP group and serum levels of sCD40 in dust contacted control group were not significantly lower（P0.05）.In comparison with CWP stageⅠ,serum level of sCD40 in CWP stage Ⅱ was significantly higher（P0.01）.Serum level of sCD40 in CWP with pulmonary tuberculosis was significantly higher than those in simple CWP（P0.01）,while serum levels of sCD40 and sCD40L in CWP had no significant differences among three subgroups of dust contacted time （P0.05）.There was positive correlation between serum levels of sCD40 and sCD40L in control group,dust contacted control group and CWP group（r=0.624,0.579 and 0.364,P0.01）.Conclusion sCD40L might contribute to the inflammatory reaction of CWP in earlier period.sCD40 could prognosticate the seriousness of CWP.sCD40 and sCD40L could concomitantly participate in the occurrence and development of CWP.