燃煤型砷中毒患者血清CRP与肺损害关系初探  

Preliminary research on correlation of serum CRP with lung impairment of patients with coal-arsenic poisoning

作　　者：杨运旗[1] 陈吉[1] 李新顺[1] 胡昭宇[2] 陈宁[2] 张爱华[3] 沈毅[3] 

机构地区：[1]解放军44医院呼吸科,贵阳550009 [2]解放军44医院检验病理科,贵阳550009 [3]贵阳医学院公共卫生学院

出　　处：《西南国防医药》2014年第10期1045-1046,共2页Medical Journal of National Defending Forces in Southwest China

基　　金：国家自然科学基金资助项目(30060077);全军医学基金资助项目(01MA048)

摘　　要：目的探讨燃煤型砷中毒患者血清C反应蛋白(CRP)与肺病理损害之间的关系。方法对22例慢性燃煤型砷中毒患者分别行血清CRP检测和肺活检术,分析血清CRP水平与患者燃用高砷煤时间及肺组织学检测结果之间的关系。结果患者血清CRP检测结果为(59.4±3.5)mg/L,与正常人群相比显著升高(P<0.01);血清CRP水平与燃用高砷煤时间呈显著正相关(r=0.708,P<0.01)。肺组织病理学改变以肺间质纤维化、炎性细胞浸润及两者并存为其主要特征,3种病变患者间血清CRP水平无统计学差异(P>0.05),但分别高于正常人群参考值上限(30 mg/L)的1.83、2.15和1.92倍(P<0.01)。结论血清CRP水平与燃煤型砷污染所致肺损害具有一定关联性;长期吸入毒性较高的三价砷为肺组织损害的直接原因,由此产生的炎性反应参与并加重肺组织损害过程;动态监测血清CRP变化,对评估燃煤型砷中毒患者肺损害程度及干预效果具有临床意义。Objective To research the correlation of serum C-reactive protein（CRP）with lung impairment of patients with coal-arsenic poisoning.Methods Serum CRP examination and lung biopsy were carried out for 22 patients with chronic coal-arsenic poisoning,respectively,so as to analyze the correlation of the level of serum CRP with the time using high-arsenic coal and the lung tissue examination results.Results The level of serum CRP of these patients was（59.4 ± 3.5） mg /L,which was significantly higher than that of the normal people（P〈0.01）;the level of serum CRP was positively correlated with the time using high-arsenic coal（r = 0.708,P〈0.01）.The pathological changes of lung tissues were featured with pulmonary interstitial fibrosis and inflammatory cell infiltration or both,and the levels of serum CRP among the patients with any one of the above pathological changes had no significant difference（P〈0.05）,while it was higher than the reference limit of the normal people（30 mg /L）by 1.83,2.15 and 1.92 times（P〈0.01）.Conclusion There is a certain correlation of the level of serum CRP with lung impairment caused by coal-arsenic pollution;the direct cause to lung impairment is long-term inhalation of high-toxicity trivalent arsenic,which results in inflammatory reaction and takes part in the exacerbation of the lung impairment;it is significant clinically to monitor dynamically the changes of serum CRP for evaluation of the degree of lung impairment caused by coal-arsenic poisoning and the intervention effects.

关 键 词：燃煤 砷中毒 C反应蛋白 肺损害 

分 类 号：R595[医药卫生—内科学]