矽尘接触者及患者氧化应激指标及TGF-β1和TNF-α的变化

Variation of oxidative stress and TGF-β1 & TNF-αlevels in the serum of workers exposed to silica dust and silicosis patients

目的观察矽肺接触者和矽肺患者血清中氧化应激指标及炎症指标的变化。方法选择70名某酒店服务人员作为对照组,100名接触矽尘作业工龄1年以上的工人作为接尘组,110名矽肺患者作为矽肺组,24例0+病例为观察组。分别测定各组对象血清中的超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活力及一氧化氮(NO)、丙二醛(MDA)含量以及转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)含量并进行比较分析。结果各组间SOD、GSH-Px、NO差异显著(P<0.05或P<0.01),矽肺组MDA含量显著高于对照组(P<0.05),矽肺组的TGF-β1显著高于接尘组和对照组(P<0.05);矽肺患者中,GSH-Px、NO、MDA、TGF-β1及TNF-α随疾病进展而增高(P<0.05或P<0.01)。结论矽肺患者血清中GSH-Px、TGF-β1及TNF-α水平与疾病进展有关,可以作为临床指标观察疾病转归。

Objective To examine the effect of continuous renal replacement （CRRT） and that of intermittent hemodialysis （IHD） on severe acute kidney injury（AKl） and to analyze the factors affecting the prognosis. Method 230 patients with severe AKI were randomly divided into two groups, a control group （n = 115） cases and an experimental group （n = 115）. The experimental group was given the continuous renal replacement therapy. The control group was treated with intermittent hemodialysis. The effects of CRRT and that of IHD were then compared. The factors affecting the prognosis were also analyzed. Findings The BUN, Set, and APACHE-II scores of both groups after treatment were significantly decreased. The scores of the CRRT group decreased more significantly （ P 〈 0. 01 ）. The HCO3- of the CRRT group increased more significantly （ P 〈 0. 01 ）. The mortality rate of the CRRT group was significantly lower than that of the IHD group. Old age （ OR = 3. 105 ） , the number of organ failure （ OR = 4. 718 ） , APACHEII scores （ OR = 3. 693 ） , severe underlying diseases （ OR = 7. 847）, were independent risk factors causing death in patients with severe AKI（P 〈 O. 05. Conclusion Compared with IHD, the effect of CRRT treatment of severe AKI is more significant. The survival rate was high and better able to maintain a stable internal environment. Old age, the number of organ failure, APACHEII scores, and severe underlying diseases are independent risk factors causing death in patients with severe AKI.