大容量双肺灌洗对煤尘肺患者免疫细胞和细胞因子的影响

Massive whole-lung lavage impact on immune cells and cytokines in patients with pneumoconiosis

目的分析大容量双肺灌洗（Massive whole-lung lavage,MWLL）对煤尘肺患者免疫细胞及细胞因子的影响,为煤尘肺患者的治疗提供依据。方法对70例煤尘肺患者实施MWLL治疗,共灌洗10-15次,治疗前、治疗后采用酶联免疫吸附法检测血清肿瘤坏死因子-α（TNF-α）、Clara细胞分泌蛋白-10（CC-10）、转化因子-β1（TGF-β1）,采用流式细胞仪检测外周血T细胞亚群。结果治疗后Ⅰ期、Ⅱ期患者CD4^＋、CD8^＋、CD4^＋/CD8^＋比值、TNF-α、TGF-β1、CC-10与治疗前比较,差异有统计学意义（P〈0.05或P〈0.01）;Ⅲ期患者治疗后CD4^＋、CD4^＋/CD8^＋比值、TNF-α、TGF-β1与治疗前比较,差异有统计学意义（P〈0.05）,但治疗前、后CD8^＋、CC-10比较,差异无统计学意义（P〉0.05）。结论 MWLL治疗在短期内能改善煤尘肺患者的体液免疫及细胞免疫。

Objective To analyze MWLL impact on immune cells and cytokines in patients with pneumoconiosis,and to provide the basis for coal pneumoconiosis patients. Methods 70 cases of pneumoconiosis implement MWLL treatment of lavage 10 to 15 times,by enzyme-linked immunosorbent assay of serum tumor necrosis factor-α（TNF-α）,Clara cell secretory protein 10（CC-10）,transforming growth factor-β1（TGF-β1）,the use of flow cytometry in peripheral blood T cell subsets before and after treatment. Results CD4^＋,CD8^＋,CD4^＋/CD8^＋ratio,TNF-α,TGF-β1,CC-10 of periodⅠ,Ⅱpatients,the difference was statistically significant after treatment compared with before treatment（P〈0.05 or P〈0.01）;CD4^＋,CD4^＋/CD8＋ratio,TNF-α,TGF-β1 of period Ⅲ patients,the difference was statistically significant after treatment compared with before treatment（P〈0.05,but the difference of CD8＋,CC-10 was not statistically significant（P〈0.05）.Conclusion MWLL treatment can improve coal pneumoconiosis humoral and cellular immunity in the short term.