尘肺患者血清中维生素D和透明质酸水平与患者病情分级和肺功能的关系

The correlation of serum vitamin D and hyaluronic acid in patients with pneumoconiosis with grade of disease and pulmonary function

目的探讨尘肺患者血清中维生素D活性代谢产物[1,25-(OH)_2D3]和透明质酸(HA)水平与尘肺的病情分级和肺功能之间的关系。方法入选确诊为尘肺的Ⅰ期~Ⅲ期患者96例及同期无粉尘接触史的健康体检者30例为研究对象,均为男性,使用肺功能仪测定第1 s用力呼气容积(FEV1)、用力肺活量(FVC)、最大通气量(MVV),计算各肺功能指标占预计值的百分比,并采用电化学发光法测定血清1,25-(OH)_2D_3水平,酶联免疫吸附法测定血清HA水平。结果Ⅲ期尘肺患者的FEV1、FVC、FEV1/FVC、MVV值均低于Ⅰ期、Ⅱ期和对照组;Ⅰ期、Ⅱ期、Ⅲ期尘肺患者的血清1,25-(OH)_2D_3水平Ⅰ期、Ⅱ期、Ⅲ期尘肺患者的血清1,25-(OH)_2D_3均明显低于对照组,HA水平均明显高于对照组,差异均有统计学意义(P<0.05)。血清1,25-(OH)_2D_3与FEV1、FEV1/FVC呈正相关(P<0.05),与FVC、MVV无相关性(P>0.05)。血清HA与FEV1、FVC、FEV1/FVC、MVV均无相关性(P>0.05)。结论维生素D和血清纤维化指标HA与尘肺的发生发展有关,且通过测定血清1,25-(OH)_2D_3水平对判断尘肺患者的肺功能损伤程度有一定的实用意义。

Objective To investigate the correlation of serum active metabolite of vitamin D [1,25-（OH）2D3]and hyaluronic acid（ HA） in patients with pneumoconiosis with the grade of disease and pulmonary function. Methods 96 cases diagnosed as Ⅰ-Ⅲ pneumoconiosis and 30 patients without dust exposure were collected,and all of them were male. The forced expiratory volume in one second（ FEV1）,forced vital capacity（ FVC） and maximal ventilation volume（ MVV） were determined by using a lung function instrument,and the percentage of each lung function indexs were calculated,the levels of serum 1,25-（OH）2D3 were determined by electrochemiluminescence,and the level of serum HA were determined by enzyme-linked immunosorbent assay. Results The values of FEV1,FVC,FEV1/FVC and MVV of patients with pneumoconiosis in phase III were lower than that in phase I,phase II and the control group; the levels of serum 1,25-（OH）2D3 of pneumoconiosis patients within phase I,phase II and phase III were significantly lower than those of the control group,and the levels of HA were significantly higher than those of the control group,with the differences statistically significant（ P〈0. 05）. Serum 1,25-（OH）2D3 was positively correlated with FEV1 and FEV1/FVC（ P〈0. 05）,and had no correlation with FVC and MVV（ P〈0. 05）.There was no correlation between serum HA and FEV1,FVC,FEV1/FVC,MVV（ P〉0. 05）. Conclusion Vitamin D and serum fibrosis index HA are related to the occurrence and development of pneumoconiosis,and the determination of serum 1,25-（OH）2D3 has practical significance in judging the degree of lung function damage in pneumoconiosis patients.