煤工尘肺患者血清和肺泡灌洗液中肿瘤坏死因子-α水平与肺功能关系研究  

Correlation analysis between serum and bronchoalveolar lavage fluid TNF-α and the lung function of coal workers' pneumoconiosis

作　　者：郭伟[1,2] 王平 杨华敏 赵凤玲 吕玉民 黄汉林[3] 王静[1] 

机构地区：[1]郑州大学第一附属医院呼吸科,河南郑州450052 [2]河南省职业病防治研究院,450052 [3]广东省职业病防治院,广东广州510300

出　　处：《中国职业医学》2016年第1期48-51,共4页China Occupational Medicine

基　　金：国家科技支撑计划项目(2014BAI12B01);国家重点临床职业病专科建设项目(2011-17)

摘　　要：目的探讨煤工尘肺(CWP)患者血清和支气管肺泡灌洗液(BALF)中肿瘤坏死因子-α(TNF-α)在CWP发病过程中的作用与意义。方法采用立意抽样方法,将28例CWP患者根据期别分为CWP壹期组7例、CWP贰期组10例、CWP叁期组11例,分别收集患者血清和BALF,用化学发光法检测其中的TNF-α水平,并对患者进行肺功能检查。结果 CWP患者血清中TNF-α水平与CWP期别呈正相关[Spearman相关系数(rS)=0.843,P<0.01],与1秒率(FEV1/FVC)呈负相关(rS=-0.503,P<0.01)。CWP患者BALF中TNF-α水平与CWP期别呈负相关(rS=-0.654,P<0.01),与FEV1/FVC呈正相关(rS=0.432,P<0.05);CWP患者血清和BALF中TNF-α水平呈负相关(rS=-0.561,P<0.01)。结论 CWP患者血清和BALF中TNF-α水平随着CWP期别的增高呈现不同的变化趋势,且与肺功能的改变有关联;TNF-α可作为评估CWP病情严重程度的参考指标。Objective To explore the effect and significance of tumor necrosis factor-α（ TNF-α） in serum and bronchoalveolar lavage fluid（ BALF） of coal workers＇ pneumoconiosis（ CWP）. Methods Twenty-eight cases of CWP were selected by purposive sampling method and divided into 3 groups based on different stages of pneumoconiosis. There were 7 cases in stage Ⅰ,10 cases in stage Ⅱ,and 11 cases in stage Ⅲ. The venous blood and BALF were collected.TNF-α in the serum and BALF were detected by chemiluminescence assay. The lung function was determined. Results In the serum,the TNF-α level of CWP patients was positively correlated with the CWP stage [Spearman correlation coefficient（ rS） = 0. 843,P〈0. 01],and negatively correlated with the forced expiratory volume in one second/forced vital capacity（ FEV1/ FVC）（ rS=- 0. 503,P〈0. 01）. In BALF,the TNF-α level of CWP patients was negatively correlated with the CWP stage（ rS=- 0. 654,P〈0. 01）,and positively correlated with the FEV1/ FVC（ rS= 0. 432,P〈0. 05）. The TNF-α level in the serum was negatively correlated with the TNF-α level in BALF（ rS=- 0. 561,P〈0. 01）.Conclusion With the development of pneumoconiosis,the levels of TNF-α in the serum and BALF showed different variation,and were correlated with the changes of FEV1/ FVC. The level of TNF-α could be used as a reference index for evaluating the severity of CWP.

关 键 词：煤工尘肺 血清 支气管肺泡灌洗液 肿瘤坏死因子-Α 肺功能 

分 类 号：R135.2[医药卫生—劳动卫生]