开滦(集团)有限责任公司接尘工人和煤工尘肺患者血清自身抗体测定

Determination of serum autoantibodies in dust-exposed workers and coal workers' pneumoconiosis patients in Kailuan(Group)limited liability corporation

目的探讨自身抗体在开滦(集团)有限责任公司接尘工人和煤工尘肺(CWP)患者血清中的水平及变化。方法采用酶联免疫吸附法测定开滦(集团)有限责任公司233例煤矿接尘工人和412例壹期CWP患者血清抗核抗体(ANA)、抗M2型线粒体抗体(AMA-M2)、髓过氧化物酶(MPO)抗体和抗环瓜氨酸肽(CCP)抗体;胶乳增强免疫比浊法检测类风湿因子(RF),并根据是否合并慢性阻塞性肺疾病(COPD)进行分析。结果与正常组比较,接尘组和CWP组血清中ANA、AMA-2均明显升高,差异均有统计学意义(均P<0.01);CWP组血清ANA和AMA-2水平[22.2(15.6,30.6)U/ml和7.2(5.8,9.0)RU/ml]高于接尘组水平[18.2(13.3,25.5) U/ml和7.0(4.3,8.0) RU/ml],差异均有统计学意义(均P<0.01);MPO、抗CCP抗体和RF在3组间水平比较均无明显变化(均P>0.05)。单纯CWP和CWP合并COPD患者血清ANA、AMA-M2、抗CCP抗体、MPO抗体和RF水平均无明显变化,差异均无统计学意义(均P>0.05)。结论开滦(集团)有限责任公司接尘工人和壹期CWP患者血清中ANA和AMA-M2水平升高,CWP组尤为明显,可能对CWP合并自身免疫性疾病的诊断和预防有一定的价值。

[Objective]To explore the levels and changes of autoantibodies in dust-exposed workers and patients with coal workers’ pneumoconiosis(CWP) in Kailuan(Group) limited liability corporation.[Methods]233 cases dust-exposed workers and 412 cases of stage Ⅰ CWP patients in Kailuan(Group) limited liability corporation were selected. The Anti-nuclear antibody(ANA),antimitochondrial M2 antibody(AMA-M2),myeloperoxidase(MPO) and anti-cyclic citrullinated peptide antibody(CCP) were detected by enzyme-linked immunosorbent assay,rheumatoid factors(RF) was detected by enhanced immunoturbidity of latexa. The results were analyzed according to the people with chronic obstructive pulmonary disease(COPD) or not.[Results]Compared with the normal group,the serum levels of ANA and AMA-M2 in dust-exposed group and CWP group were significantly increased,and the differences were statistically significant(both P<0.01). The serum levels of ANA and AMA-M2 in CWP group[22.2(15.6,30.6) U/ml and7.2(5.8,9.0) RU/ml] were higher than those in dust-exposed group[18.2(13.3,25.5) U/ml and 7.0(4.3,8.0) RU/ml],and the differences were statistically significant(both P<0.01). There were no statistically significant differences in levels of MPO, anti-CCP and RF among the three groups(all P>0.05). There were no statistically significant differences in levels of ANA,AMA-M2,anti-CCP,MPO and RF betw een simple CWP group and CWP with COPD group(all P >0.05).[Conclusion]Serum levels of ANA and AMA-M2 are elevated in dust-exposed workers and stage Ⅰ CWP patients in Kailuan(Group) limited liability corporation especially rising obviously in CWP patients,which might be valuable to the early prevention and diagnosis of CWP.