煤工尘肺患者血清中自身抗体检测  

Detection of autoantibodies in serum of patients with coal workers' pneumoconiosis

作　　者：王冬梅[1] 袁宝军[1] 李超[1] 高利常[1] 崔晶晶 WANG Dongmei;YUAN Baojun;LI Chao;GAO Lichang;CUI Jingjing(Kai Luan General Hospital, Tangshan, Hebei 063000, Chin)

机构地区：[1]开滦总医院,河北唐山063000

出　　处：《中国职业医学》2018年第3期350-354,共5页China Occupational Medicine

摘　　要：目的探讨煤工尘肺(CWP)患者血清中自身抗体的检出情况。方法采用随机抽样法,以803例CWP壹期患者为研究对象,采用间接免疫荧光法检测其血清中抗核抗体和抗中性粒细胞胞浆抗体(ANCA),采用酶联免疫吸附法检测其血清中髓过氧化物酶(MPO)抗体、抗M2型线粒体抗体(AMA-M2)和抗环瓜氨酸肽(CCP)抗体,采用胶乳增强免疫比浊法检测其血清中类风湿因子(RF),依据年龄、肺功能、接尘年限及接尘性质进行分组分析。结果 803例CWP患者血清中抗核抗体、AMA-M2、RF、抗CCP抗体、ANCA、MPO抗体的阳性率分别为9.7%、7.5%、7.3%、4.0%、2.6%和0.8%;78例抗核抗体阳性标本的核型分布为:颗粒型(43.6%)、胞浆型(20.5%)、均质型(7.7%)和核仁型(5.1%),滴度均为1:100。年龄>70.0组CWP患者抗核抗体阳性率高于年龄~60.0和~70.0岁组(P<0.017);肺功能异常组CWP患者抗核抗体阳性率高于正常组(P<0.01);接尘年限>30.0年组CWP患者抗CCP抗体阳性率高于接尘年限~30.0年组(P<0.017);矽尘组CWP患者抗CCP抗体阳性率低于煤尘组(P<0.01)。结论 CWP患者血清中抗核抗体、AMA-M2、RF和抗CCP抗体阳性率较高;抗核抗体阳性率与年龄和肺功能有关,抗CCP抗体阳性率与接尘年限和接尘性质有关。Objective To explore the detection of autoantibodies in serum of patients with coal workers＇ pneumoconiosis（ CWP）.Methods Eight hundred and three cases of stage Ⅰ CWP patients were selected as study subjects by random sampling method.Anti-nuclear antibody and anti-neutrophil cytoplasmic antibody（ ANCA） in serum were detected by indirect immunofluorescence assay; myeloperoxidased efficiency（ MPO） antibody,anti-mitochondrial M2 antibody（ AMA-M2） and anti-cyclic citrullinated peptide（ CCP） antibody were detected by enzyme-linked immunosorbent assay;rheumatoid factor（ RF） was detected by enhanced immunoturbidimetry of latexa.Group analysis was conducted according to age,lung function,length of dust exposure and the nature of dust exposure collection.Results In the serum of 803 CWP patients,the positive rate of anti-nuclear antibody,AMA-M2,RF,anti-CCP antibody,ANCA and MPO antibody were 9.7%,7.5%,7.3%,4.0%,2.6% and 0.8% respectively; the karyotype distribution of 78 cases of anti-nuclear antibody positive specimens was spotted（ 43.6%）, cytoplasmic（ 20.5%）, homogenous（ 7.7%） and nucleolus（ 5.1%）,with a titer of 1：100.The positive rate of anti-nuclear antibody in the 〉70.0 years group was higher than that of ≤60.0 and ≤70.0 years group（ P〈0.017）; the positive rate of anti-nuclear antibody in the abnormal lung function group was lower than that of the normal group（ P〈0.01）; the positive rate of anti-CCP antibody in the dust exposure length 30.0 years group was higher than that of ≤30.0 years group（ P〈0.017）; the positive rate of anti-CCP antibody in silica-exposed group was lower than that in the coal-exposed group（ P〈0.01）.Conclusion The positive rate of antinuclear antibody,AMA-M2,RF and anti-CCP antibody in CWP patients were high.The positive rate of anti-nuclear antibody is associated with age and lung function.The positive rate of anti-CCP antibody is related to the duration and nature of dust exposure.

关 键 词：煤工尘肺 自身抗体 抗核抗体 抗中性粒细胞胞浆抗体 抗M2型线粒体抗体 抗环瓜氨酸肽抗体 类风湿因子 

分 类 号：R135.2[医药卫生—劳动卫生]