壹期煤工尘肺患者外周血白细胞亚群水平及意义  

Levels and significance of peripheral leukocyte subsets in patients with stage Ⅰ coal workers' pneumoconiosis

作　　者：袁宝军[1] 李超[1] 王玉寒[1] 佟艳艳[1] 张蜀澜[2] 李永哲[2] 

机构地区：[1]开滦总医院检验科,河北唐山063000 [2]北京协和医院风湿免疫科,北京100032

出　　处：《环境与职业医学》2018年第1期49-54,共6页Journal of Environmental and Occupational Medicine

摘　　要：[目的]探讨壹期煤工尘肺(CWP)患者外周血白细胞亚群水平变化及意义。[方法]采用五色流式细胞术检测66例壹期CWP患者(CWP组)、47例与CWP组相同接尘条件的井下接尘矿工(接尘组)及40例非接尘的井上健康工人(非接尘组)外周血白细胞亚群水平,并根据CWP组中是否吸烟、有无并发症、接尘年限及肺功能损伤程度进行分析。[结果]与非接尘组[3.76%(2.97%~4.94%)、5.63%(4.69%~6.63%)、6.12%(5.14%~7.21%)、2.07%(1.28%~3.03%)、0.79%(0.58%~0.98%)]相比,CWP组外周血B淋巴细胞、CD16-单核细胞、总单核细胞、嗜酸性粒细胞、嗜碱性粒细胞水平[4.47%(3.41%~5.92%)、6.47%(5.71%~7.81%)、6.88%(6.18%~8.45%)、2.70%(2.07%~3.80%)、0.97%(0.76%~1.22%)]增高,差异均有统计学意义(P<0.05);与接尘组[3.94%(3.25%~4.59%)、2.04%(1.13%~3.29%)、7.50%(5.91%~11.13%)]相比,CWP组外周血B淋巴细胞、嗜酸性粒细胞水平[4.47%(3.41%~5.92%)、2.70%(2.07%~3.80%)]增高,细胞毒性T+NK[6.44%(4.47%~9.16%)]降低,差异有统计学意义(P<0.05);接尘组外周血细胞毒性T+NK细胞、总单核细胞、CD16-单核细胞水平高于非接尘组,差异有统计学意义(P<0.05);3组中性粒细胞差异无统计学意义(P>0.05)。CWP组中,与非吸烟者相比,吸烟者外周血总淋巴细胞、B淋巴细胞增高,成熟中性粒细胞降低,差异均有统计学意义(P<0.05)。其他相关临床指标间比较,白细胞亚群水平差异均无统计学意义(P>0.05)。[结论]壹期CWP患者白细胞亚群(B淋巴细胞、细胞毒性T+NK细胞及嗜酸性粒细胞)水平异常,吸烟可能影响CWP患者白细胞亚群水平。[ Objective ] To explore the changes and significance of peripheral leukocyte subsets in patients with stage I coal workers＇ pneumoconiosis （CWP）. [ Methods ] Levels of peripheral leukocyte subsets were determined in 66 patients with diagnosis of stage I CWP （CWP group）, 47 healthy underground coal workers with the same dust exposure as the CWP group （dust-exposed group）, and 40 healthy ground coal workers without dust exposure （non-dust-exposed group） by five-color flow cytometry. The CWP group was further evaluated based on smoking, complication, duration of exposure to dust, and pulmonary function impairment. [ Results ] Compared with the non-dust-exposed group [3.76% （2.97%-4.94%）, 5.63% （4.69%-6.63%）, 6.12% （5.14%-7.21%）, 2.07% （1.28%-3.03%）, and 0.79% （0.58%-0.98%）], the levels of B lymphocytes, CDI6-monocytes, total monocytes, eosinophils, and basophils in the CWP group [4.47% （3.41%-5.92%）, 6.47% （5.71%-7.81%）, 6.88% （6.18%-8.45%）, 2.70 %（2.07%-3.80%）, and 0.97% （0.76%-1.22%）] were significantly increased （P 〈 0.05）. Compared with dust-exposed group [3.94% （3.25%-4.59%）, 2.04% （1.13%-3.29%）, 7.50% （5.91%-11.13%）], the levels of B lymphocytes and eosinophils [4.47% （3.41%-5.92%）, 2.70% （2.07%-3.80%）] in the CWP group were increased, whereas the level of cytotoxic T＋NK cells [6.44% （4.47%-9.16%）] was decreased （P〈0.05）. The levels of cytotoxic T^NK cells, total monocytes, and CD16-monocytes in the dust-exposed group were significantly higher than those in the non-dust-exposed group （P 〈 0.05）. Neutrophils were not different among the three groups （P 〉 0.05）. For the CWP group, increased levels of peripheral total lymphocytes and B lymphocytes and decreased level of mature neutrophils were found in the smoking patients compared with the non-smoking patients （P〈0.05）. There were no differences in leukocyte subsets among patients grouped by other clinical indicators （P〉 0.05）. [ Conclusion ]

关 键 词：煤工尘肺 五色流式细胞术 白细胞亚群 

分 类 号：R135.2[医药卫生—劳动卫生]