尘肺患者诱导痰与肺灌洗液中炎性因子的差异和相关性研究

Observation of the inflammatory factors level and the correlation between induced sputum and whole lung lavage fluid for silicosis

目的 检测尘肺患者诱导痰液和全肺灌洗液中炎性因子的水平及其相关性.方法 选择45例尘肺患者依次进行肺功能测定、痰液诱导和双肺同期大容量全肺灌洗（WLL）.收集痰液和灌洗液,酶联免疫吸附试验（ELISA）检测2种标本中炎性因子巨噬细胞炎性蛋白（MIP）-1α、单核细胞趋化因子（MCP）-1、白细胞介素（IL）-16、NO2^-/NO3^-和肿瘤坏死因子（TNF）-α的水平并分析其相关性,分析炎性因子水平与肺功能指标的相关性.结果 尘肺患者的诱导痰和全肺灌洗液中MCP-1、TNF-α、NO2^-/NO3^-及IL-16水平均呈明显正相关（P＜0.05）;诱导痰和全肺灌洗液中TNF-α、MCP-1、NO2^-/NO3^-及IL-16与肺功能指标无明显相关关系（P＞0.05）,MIP-1α与FEV1.0/VCmax、MEF25呈明显正相关关系（P＜0.05）.结论 尘肺患者诱导痰和全肺灌洗液中炎性因子水平有显著相关性,并可反映早期肺损伤程度.

Objective To detect the inflammatory factors of induced sputum （IS） and whole lung lavage fluid in pneumonoconiosis patients and to explore the correlation between the inflammatory factors with pulmonary function.Methods The records of 45 cases of pneumonoconiosis patients were observed.All patients underwent lung function examination,sputum induction and massive whole lung lavage （WLL）sequentially through advance.IS and whole lung lavage fluid were collected respectively.Inflammatory factors of the two specimens were detected by using enzyme linked immunosorbent assay.The correlation of inflammatory factors between the two specimens was analyzed.The relationship between the inflammatory factor and lung function index was observed.The statistical analysis is performed with SPSS 17.0 for Windows.P〈0.05is considered to be statistically significant.Results Cytokines（MCP-1 、TNF-α、MIP-1α 、NO2^-/NO3^-and IL-16）were significantly associated between IS and whole lung lavage fluid（P〈0.05）,while TNF-α、MCP-1 、NO2^-/NO3^-and IL-16 were no significantly associated with lung function index （P〉0.05）.MIP-1α was significantly associated with FEV1.0/VCmax and MEF25,respectively （P〈0.05）.Conclusions Inflammatory factors were significantly associated between IS and whole lung lavage fluid,which could indicate early lung injury in pneumonoconiosis patients.