尘肺病患者肺泡灌洗液TNF-α、IL-10、Th1/Th2水平的临床意义

Clinical significance of TNF-α,IL-10 and Th1/Th2 levels in alveolar lavage fluid of patients with pneumoconiosis

目的探究肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)、辅助T细胞1/2(Th1/Th2)在尘肺病患者中的表达情况及临床意义。方法选择2016年12月-2019年8月在皖北煤电集团总医院进行治疗的72例尘肺病患者作为研究对象,另选取80例非尘肺病患者作为对照组,收集支气管肺泡灌洗液(BALF),采用酶联免疫法检测BALF中TNF-α、IL-10水平,流式细胞术检测BALF中Th1、Th2细胞比例,对所有患者肺功能指标1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC进行检测;采用Pearson相关性分析TNF-α、IL-10、Th1/Th2与肺功能指标FVC、FEV1、FEV1/FVC的关系;采用logistic回归分析影响尘肺病的危险因素。结果与对照组相比,尘肺病患者BALF中TNF-α、Th2水平升高,Th1、Th1/Th2、IL-10降低;随着尘肺病情程度的加重,TNF-α、Th2水平升高,IL-10、Th1、Th1/Th2降低(P<0.05)。与对照组相比,尘肺病患者FVC、FEV1、FEV1/FVC升高(P<0.05)。Logistic回归分析显示,TNF-α、IL-10、Th1/Th2、FEV1/FVC是影响尘肺病患病的危险因素(均P<0.05)。Pearson相关性分析发现,TNF-α与IL-10、Th1/Th2成负相关,IL-10与Th1/Th2成正相关(r=-0.347、-0.459、0.483,均P<0.01)。TNF-α与FVC、FEV1、FEV1/FVC成正相关,Th1/Th2、IL-10与FVC、FEV1、FEV1/FVC成负相关(P<0.05)。结论尘肺病患者BALF中TNF-α、IL-10水平升高,Th1/Th2细胞比率降低,与患者病情程度及肺功能异常有关。

Objective To investigate the expressions and clinical significance of tumor necrosis factor-α (TNF-α),interleukin-10(IL-10)and helper T cell 1/2(Th1/Th2) in patients with pneumoconiosis. Methods 72 cases of pneumoconiosis treated in Wanbei Coal Power Group General Hospital from Dec 2016 to August 2019 were selected as the research objects,and 80 cases of nonpneumoconiosis were selected as the control group. Bronchoalveolar lavage fluid(BALF) was collected,the levels of TNF-α and IL-10 in BALF were detected by ELISA,the percentages of Th1 and Th2 cells in BALF were detected by flow cytometry,all subjects’ pulmonary function indexes including forced expiratory volume in one second(FEV1),forced vital capacity(FVC) and FEV1/FVC were measured. Pearson correlation analysis was used to analyze the relationships between TNF-α,IL-10,Th1/Th2 and lung function indexes FVC,FEV1,FEV1/FVC,and logistic regression analysis was used to analyze the risk factors of pneumoconiosis.Results Compared with the control group,the levels of TNF-α and Th2 in BALF of pneumoconiosis patients increased,Th1,Th1/Th2 and IL-10 decreased,and with the aggravation of pneumoconiosis,the level of TNF-α and Th2 increased,IL-10,Th1 and Th1/Th2 decreased(P<0.05). Compared with the control group,FVC,FEV1 and FEV1/FVC in pneumoconiosis patients increased(P<0.05).Logistic regression analysis showed that TNF-α,IL-10,Th1/Th2 and FEV1/FVC were risk factors for pneumoconiosis(all P<0.05).Pearson correlation analysis showed that TNF-α was negatively correlated with IL-10 and Th1/Th2,and IL-10 was positively correlated with Th1/Th2(r =-0.347,-0.459,0.483,all P <0.01). TNF-α was positively correlated with FVC,FEV1,FEV1/FVC,while Th1/Th2 and IL-10 were negatively correlated with FVC,FEV1,FEV1/FVC(P<0.05). Conclusion The levels of TNF-α and IL-10 in BALF of pneumoconiosis patients increase,and the ratio of Th1/Th2 cells decreases,which are related to the severity of pneumoconiosis and abnormal pulmonary function.