早期矽肺患者支气管肺泡灌洗液中生物标志物的研究

Biological markers in brochoalveolar lavage fluid of early silicosis patients

目的 探讨早期矽肺患者支气管肺泡灌洗液 (BALF)中生物标志物。方法 矽尘作业工人 18人 ,按X线诊断矽肺期别分为 0 +组和Ⅰ期组 ;以健康吸烟农民 7人为对照组。经纤支镜支气管肺泡灌洗收集BALF ,进行细胞学检验 ,用细胞毒性试验测定肿瘤坏死因子 (TNF α)含量 ,酶联免疫吸附法测定其他细胞因子含量。结果 矽肺 0 +组及Ⅰ期组BALF中TNF α含量分别为 (7.2 0±1.87)、(9.2 0± 1.10 )U/ml,明显高于对照组的 (5 .71± 0 .89)U/ml,差异有显著性 (P <0 .0 1) ;矽肺Ⅰ期组TNF α含量明显高于 0 +组 ,差异有显著性 (P <0 .0 5 )。TNF α含量与矽尘接触年限存在剂量 -效应关系 (rs=0 .46 98,P <0 .0 5 )。纤维连接蛋白、肺表面活性蛋白A和前胶原Ⅲ肽与对照比较 ,差异无显著性 (P >0 .0 5 )。结论 BALF中TNF

Objective To study the biomarkers in brochoalveolar lavage fluid(BALF) of early silicosis patients.Methods The concentration of TNF α,SP A and other cytokines in BALF of 18 silicosis patients with stage 0 + and Ⅰ,and 7 healthy smoking peasants as a control group were measured.BALF was collected with fibroendoscopy and concentrations of TNF α were analyzed with cytotoxicity assay,SP A and other cytokines were measured with ELISA.Results The levels of TNF α in BALF in stage 0 + and I silicosis group were (7.20±1.87)U/ml and (9.20±1.10)U/ml respectively,higher than that in the control group (5.71±0.89)U/ml( P <0.01).There was dose effect relationship between the level of TNF α and exposure time( r s =0.469 8, P <0.05).The levels of fibronectin,surfactant protein A and type Ⅲ procollagen peptide in BALF between 0 + or Ⅰstage of silicosis group and the control group were not significantly different.Conclusion The increased concentration of TNF α in BALF may be an effective biomarker for early silicosis.