铜蓝蛋白与脂质过氧化产物和血管紧张素Ⅰ转化酶与矽肺的关系研究

The clinical significance of serum ceruloplasmin,lipid peroxidation products,angiotensin Ⅰ converting enzyme in silicosis

目的探讨矽肺患者血清铜蓝蛋白(ceruloplasmin,CP)、脂质过氧化产物(lipid peroxide,LPO)和血管紧张素Ⅰ转化酶(angiotensin Ⅰ converting enzyme,ACE)水平及意义。方法回顾性分析2016年1月至2018年12月浙江省医疗健康集团长兴医院治疗的矽肺患者72例(观察组),其中矽肺Ⅰ期20例,Ⅱ期36例,Ⅲ期16例,同时选取与观察组相同接尘条件的工人60例(对照组),非接尘健康体检者60例(健康组),检测各组血清CP、LPO和ACE水平。结果观察组血清CP(3087.55±542.31)U/L,高于对照组和健康组,差异有统计学意义(t=8.121、10.124,P<0.05),而ACE(17.42±3.11)U,低于对照组和健康组,差异有统计学意义(t=6.511、8.124,P<0.05);观察组血清LPO(7.80±1.20)mol/L,高于健康组,差异有统计学意义(t=6.031,P<0.05),与对照组比较差异无统计学意义(t=1.541,P>0.05);Ⅲ期患者血清LPO高于Ⅰ期、Ⅱ期患者,差异有统计学意义(t=5.154、8.122,P<0.05),而ACE低于Ⅰ期、Ⅱ期患者,差异有统计学意义(t=6.031、9.151,P<0.05);Ⅲ期患者血清CP高于Ⅰ期患者,差异有统计学意义(t=4.551,P<0.05),而与Ⅱ期患者比较差异无统计学意义(t=1.034,P>0.05);Ⅱ期患者血清LPO高于Ⅰ期,差异有统计学意义(t=5.021,P<0.05),而ACE低于Ⅰ期患者(t=4.811,P<0.05);LPO与病情分期呈正相关(rs=0.341,P<0.05),ACE与病情分期呈负相关(rs=-0.315,P<0.05)。结论矽肺患者血清CP、LPO水平升高,而ACE水平降低,其中LPO、ACE与患者病情分期有一定相关性。

Objective To elucidate the clinical significance of serum ceruloplasmin(CP),lipid peroxidation products(LPO)and angiotensin I converting enzyme(ACE)in silicosis.Methods From January 2016 to December 2018,72 patients with silicosis treated in Changxing Hospital,Zhejiang Medical and Health Group,were enrolled into the study observation group,including 20 cases of silicosis stageⅠ,36 cases of silicosis stageⅡand 16 cases of silicosis stageⅢ.Meanwhile,60 healthy workers with the same dust exposure expeience with cases(control group)and 60 healthy individuals with no dust exposure(healthy group)were also recruited as study controls.Blood samples were collected and serum levels of CP,LPO and ACE were determined and compared among each group.Results The serum CP level of the observation group(3087.55±542.31 U/L)was significantly higher than that of the control group and the health group(t=8.121,10.124,P<0.05),while the ACE level(t=8.121,10.124,17.42±3.11 U)was significantly lower(t=6.511,8.124,P<0.05).The serum LPO level in the observation group(7.80±1.20 mol/L)was significantly higher than that in the healthy group(t=6.031,P<0.05),but was similar to that in the control group(t=1.541,P>0.05).The serum level of LPO in cases with stageⅢsilicosis was significantly higher than that in patients with stage Ⅰ andⅡ(t=5.154,8.122,P<0.05),while the levels of ACE was significantly lower(t=6.031,9.151,P<0.05).The serum CP level in patients with stageⅢsilicosis was significantly higher than that in patients with stageⅠ(t=4.551,P<0.05),but was similar to that in patients with stageⅡ(t=1.034,P>0.05).The serum level of LPO in patients with stageⅡsilicosis was significantly higher than that in patients with stageⅠ(t=5.021,P<0.05),while the level of ACE was significantly lower(t=4.811,P<0.05).Serum LPO level was positively correlated with disease stage(r_s=0.341,P<0.05),while ACE level was negatively correlated with disease stage(r_s=-0.315,P<0.05).Conclusions Serum CP level and LPO level in patients with silicosis increase,while ACE level decreases.Serum LPO and ACE are correlated with the stage of the disease.