煤工尘肺患者氧化损伤指标的早期筛检  

Value of oxygenic injury sensitive index in the screening of the early coal workers' pneumoconiosis

作　　者：范红敏[1] 袁聚祥[1] 秦天榜[1] 邱红燕[1] 王卓[1] 任京雪[1] 

机构地区：[1]河北联合大学公共卫生学院流行病与卫生统计学科河北省重点实验室-煤炭安全与卫生实验室,唐山063000

出　　处：《卫生研究》2011年第5期579-582,共4页Journal of Hygiene Research

基　　金：河北省科技支撑计划(No.09276101D-39)

摘　　要：目的探讨煤工尘肺氧化损伤生化指标的早期筛检。方法选择112例煤工尘肺患者作为病例组,144例接尘作业的健康工人作为对照组,采用硝酸还原酶法测定血浆一氧化氮(NO)、硫代巴比妥酸法测定丙二醛(MDA)、亚硝酸盐形成法测定铜锌超氧化物歧化酶(CuZn-SOD)、改良Hafenan氏法测定谷胱甘肽过氧化物酶(GSH-Px)、尿酸酶-过氧化物酶偶联法测定尿酸(UA)、对苯二胺盐酸盐法测定铜蓝蛋白(CP)、化学比色法测定诱导型一氧化氮合酶(iNOS)及总抗氧化能力(T-AOC)。结果病例组与对照组除CP外,其他各项指标差异均有显著性(P<0.05)。ROC曲线下面积比较,MDA、T-AOC、NO和iNOS的曲线下面积大于基准线的面积(P<0.05)。三项氧化损伤指标MDA、T-AOC和iNOS联合构建的判别方程,筛检煤工尘肺的特异度为89.1%,灵敏度为77.7%,符合率为84.0%,均高于单一指标和T-AOC与MDA的串联(P<0.05)T-AOC、iNOS、MDA及NO作为煤工尘肺的早期筛检指标,其中T-AOC最佳,灵敏度70.5%,特异度为68.1%。结论 MDA、T-AOC和iNOS联合筛检较综合反映了煤工尘肺患者的氧化损伤和抗氧化水平,与单一指标及MDA+T-AOC相比降低了误判率。Objective To study the significance of oxidative injury in the screening of coal workers＇ pneumoconiosis（CWP）.Methods With the method of nitrate reductase,TBA,et al,the content of NO,MDA and other indexes of peroxidation in plasma lipid were detected in 112 patients suffering from coal workers＇ pneumoconiosis and 114 healthy coal workers as controls.Results There were statistical significant between two groups（P0.05）with the content or density of MDA,CuZn-SOD,GSH-Px,T-AOC,UA,NO and iNOS except CP.As screening index of pneumoconiosis,there were statistical significant in area under the curve（AUC）of MDA,T-AOC,NO and iNOS between the two groups by ROC.As screening index of pneumoconiosis,MDA,T-AOC,NO and iNOS can be selected as early screening index.Especially,T-AOC was the best index of four indexes（sensitivity is 70.5%,specificity is 68.1%）.Conclusion Jiont screening of MDA,T-AOC and iNOS is better than single index or series of T-AOC and MDA to the screening of CWP.

关 键 词：煤工尘肺 氧化损伤 筛检 ROC曲线 

分 类 号：R969[医药卫生—药理学]