细胞因子和T细胞亚群与尘肺分期的相关性研究

Correlation analysis between cytokines levels in serum and bronchoalveolar lavage fluid, blood T cell subsets and pneumoconiosis severity

目的探讨尘肺患者血清和支气管肺泡灌洗液（BALF）中自细胞介素（IL）-6、可溶性白细胞介素2受体（sIL-2R）和肿瘤坏死因子（TNF-α）含量及外周血T细胞亚群变化，及其与尘肺分期的相关性。方法将研究对象分为健康对照组（6例），接尘对照组（6例），尘肺组（Ⅰ期尘肺36例、Ⅱ期12例、Ⅲ期10例），ELISA法检测各组血清和BALF中IL-6、sIL-2R和TNF-α含量；流式细胞仪进行T细胞亚群分类。结果与健康对照组和接尘对照组比较，Ⅱ、Ⅲ期尘肺患者血清中IL-6和各期尘肺患者血清中sIL-2R含量明显升高，并与尘肺分期呈高度正相关（r。=O．74，r2：0．81，P〈0．05）；Ⅲ期尘肺患者血清中TNF-α的含量明显低于健康对照组和接尘对照组，并与尘肺分期呈负相关（r=-0．58，P〈0．05）。Ⅲ期尘肺患者BALF中IL-6、sIL-2R含量明显增高，TNF-α含量明显下降，差异均有统计学意义（P〈0．05）。BALF中IL-6、sIL．2R和TNF．d含量与血清含量呈正相关关系（r1=0．77，r2=0．96，r3=0．88，P〈0．05）。Ⅱ、Ⅲ期尘肺患者外周血中CD4＋T细胞比例、CD4＋／CD8＋比对照组明显下降，T细胞亚群变化与尘肺分期无相关关系。结论尘肺患者Th型细胞呈免疫抑制状态，血清和BALF中IL-6、sIL-2R和TNF-α含量与尘肺分期有关。

Objective To analyze the correlation between the pneumoconiosis severity and the cytokines levels in serum and bronchoalveolar lavage fluid （BALF） or blood T cell subsets. Methods The subjects were divided into five groups： control group （6 cases）, group exposed to dusts （6 eases） and 3 pneumoconiosis groups （36 in stage Ⅰ, 12 in stage Ⅱ and 10 in stage Ⅲ）. ELISA was used to detect IL-6, sIL-2R and TNF-α levels in serum and BALF. The subsets of blood T cells were classified by flow cytometer. Results As compared with control group and group exposed to dusts, the levels of serum IL-6 and sIL-2R in patients with Ⅱ or Ⅲ stages significantly increased, which were positively correlated with pneumoconiosis stages （r1=0.74, r2= 0.81 ,P〈0.05）. The level of serum TNF-α significantly decreased in patients with Ⅲ stages, as compared with control group and group exposed to dusts. There was a negative correlation between serum TNF-α level and pneumoconiosis severity （r=-0.58,P〈0.05）. There was a positive correlation between the levels of IL-6 ,sIL-2R and TNF-α in BALF and the levels of IL-6,sIL-2R and TNF-α in serum （r1=0.77, r2=0.96 and r3=0.88 ,P〈0.05）. The proportion of CDn＋T cells and the ratio of CD4＋/CD8＋ decreased dramatically in patients with II and III stages. But there was no correlation between these values and disease severity. Conclusion The immune function in Th cell was inhibited. The levels of IL-6, sIL-2R and TNF-α in serum and BALF were associated with the severity of pneumoconiosis.