长期接触二氧化硅粉尘对血清CC16和KL-6水平的影响  

The effects of long-term exposure to silica dust on serum CC16 and KL-6 levels

作　　者：刘静 张荣 宋海燕 夏青 赵彤彤 潘丽萍 钱小莲 Liu Jing;Zhang Rong;Song Haiyan;Xia Qing;Zhao Tongtong;Pan Liping;Qian Xiaolian(Nanjing Prevention and Treatment for Occupational Disease, Nanjing 210042, China)

机构地区：[1]南京市职业病防治院,210042

出　　处：《中华劳动卫生职业病杂志》2019年第8期567-570,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：南京市医学科技发展项目(YKK15189);十三五南京市卫生青年人才培养工程项目(QRX17197).

摘　　要：目的探讨长期接触二氧化硅粉尘对血清克拉拉细胞蛋白(CC16)和涎液化糖链抗原(KL-6)水平的影响,分析CC16和KL-6在矽肺发生、发展过程中的作用,为矽肺的早期诊断和预防提供依据.方法于2018年7月,收集2016年4月至2017年4月在南京市职业病防治院住院的壹期矽肺患者、体检的矽尘接触工人和同期社区体检不接触粉尘的人群信息,共203名男性研究对象.壹期矽肺患者作为矽肺组,共42例,尘肺诊断根据GBZ 70-2015《尘肺病诊断标准》确诊;体检的矽尘接触工人作为接尘组,共73例,为有二氧化硅粉尘接触,无尘肺病表现者;同期在社区医院体检不接触粉尘的人群作为对照组,共88例.采用酶联免疫法(ELISA)测定所有研究对象血清中CC16、KL-6的水平,比较血清中CC16、KL-6的水平在3组的差异.结果与对照组比较,矽肺组、接尘组血清CC16含量明显降低,差异有统计学意义(P<0.01);矽肺组血清中KL-6水平明显降低,差异有统计学意义(P<0.01),接尘组血清中KL-6水平明显升高,差异有统计学意义(P<0.01).血清CC16水平诊断矽肺的ROC面积为0.92(P<0.01),敏感性为81.37%,特异性为92.63%,Kappa值为0.74.结论长期接触二氧化硅粉尘可能会导致血清中CC16水平降低,血清中CC16水平对于矽肺患者鉴别有一定辅助诊断价值.Objective To investigate the effects of long-term exposure to silica dust on serum CC16 and KL-6 levels. Methods The patients with stage I silicosis who were hospitalized in our hospital from April 2016 to April 2017 were treated as silicosis group. The silica dust exposed workers without silicosis who were taken the physical examination in our hospital were taken as a dust-exposed group. The healthy control group comes from in the same period of community physical examination did not touch the dust. The levels of CC16 and KL-6 in serum of all subjects were determined by enzyme-linked immunosorbent assay (ELISA), and the levels of CC16 and KL-6 in serum were compared in three groups. Results Compared with the control group, the serum levels of CC16 in the silicosis group (P<0.01) and the dust-exposed group (P<0.01) were significantly lower. Compared with the control group, the level of serum KL-6 in the silicosis group was significantly decreased (P<0.01) compared with the control group, while the level of KL-6 in the serum of the dust-exposed group was significantly increased (P<0.01). The ROC area of CC16 for diagnosis of silicosis was 0.92 (P<0.01), with a sensitivity of 81.37%, specificity of 92.63% and Kappa value of 0.74. Conclusion Long-term exposure to silica dust may lead to a decrease in serum CC16 levels. Reduced serum CC16 levels may be useful in identifying the diagnosis of silicosis.

关 键 词：克拉拉细胞蛋白 涎液化糖链抗原 二氧化硅粉尘 矽肺 

分 类 号：R135.2[医药卫生—劳动卫生]