支气管肺泡灌洗液中金属及类金属浓度检测对尘肺病因学诊断的价值分析  

Analysis of the detection of metals and metalloids in the bronchoalveolar lavage fluid for the etiological diagnosis value of pneumoconiosis

作　　者：段维霞 叶绿素 杜航 刘聪[1] 段郁 毛隆春 Duan Weixia;Ye Lvsu;Du Hang;Liu Cong;Duan Yu;Mao Longchun(Center of Laboratory Medicine,Chongqing Prevention and Treatment Center for Occupational Diseases,Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning,the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College,Chongqing 400060,China;Department of Occupational Disease and Poisoning,Chongqing Prevention and Treatment Center for Occupational Diseases,Chongqing 400060,China)

机构地区：[1]重庆市职业病防治院实验医学中心,重庆医药高等专科学校附属第一医院职业病防治与中毒救治重庆市重点实验室,400060 [2]重庆市职业病防治院职业病与中毒科,400060

出　　处：《中华劳动卫生职业病杂志》2021年第11期844-848,共5页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：重庆市南岸区卫生和计划生育委员会医学科研攻关项目(2018-09);重庆市自然科学基金项目(cstc2019jcyj-msxmX0529);重庆市第六人民医院科研孵化基金项目(2018ZD04)。

摘　　要：目的分析尘肺病患者支气管肺泡灌洗液(BALF)中金属及类金属浓度差异,为尘肺病因学诊断提供参考依据。方法于2019年9月至2020年8月,采用整群抽样方法选择重庆市职业病防治院住院治疗、实施支气管肺泡灌洗术的47例尘肺病患者作为研究对象,调查患者的一般情况和职业史,收集BALF,应用电感耦合等离子体质谱(ICP-MS)仪检测BALF中金属及类金属浓度,采用单因素方差分析比较其在不同类别尘肺病、不同期别矽肺和不同职业史患者中的差异。结果共检测BALF中50种金属及类金属的浓度,并对其中21种进行分析,不同类别尘肺病患者BALF中锌(Zn)、锰(Mn)和锡(Sn)浓度差异均有统计学意义(F=9.959、3.635、9.488,P<0.05);不同期别矽肺患者BALF中钾(K)、镁(Mg)、铁(Fe)、Zn、铜(Cu)和镍(Ni)浓度差异均有统计学意义(F=4.271、4.334、3.588、5.120、7.340、3.905,P<0.05);Zn和Sn浓度在不同工种、暴露粉尘种类尘肺病患者中差异均有统计学意义(P<0.05)。结论检测BALF中Zn、Mn、Sn等金属可为尘肺病因学诊断提供参考依据,为尘肺病诊断方法提供新的思路。Objective To analyze the differences of the concentrations of metals and metalloids in bronchoalveolar lavage fluid(BALF)of patients with pneumoconiosis,so as to provide reference for the etiological diagnosis of pneumoconiosis.Methods From September 2019 to August 2020,47 pneumoconiosis patients hospitalized in Chongqing Prevention and Treatment Center for Occupational Diseases and undergoing bronchoalveolar lavage were selected as the research objects using cluster sampling method.The general situation and occupational history of patients were investigated by questionnaire,The BALF of 47 pneumoconiosis patients was collected,and the concentrations of metals and metalloids in BALF were detected by inductively coupled plasma mass spectrometry(ICP-MS),the differences among patients with different types of pneumoconiosis,different stages of silicosis and different occupational history were analyzed by one-way ANOVA.Results The concentrations of 50 metals and metalloids in BALF were detected,and 21 of them were analyzed.Compared with different types of pneumoconiosis,the concentrations of Zn,Mn and Sn in BALF were statistically significant(F=9.959,3.635,9.488,P<0.05).The concentrations of K,Mg,Fe,Zn,Cu and Ni in BALF were significantly different in different stages of silicosis(F=4.271,4.334,3.588,5.120,7.340,3.905,P<0.05).The concentrations of Zn and Sn in pneumoconiosis patients with different types of work and types of exposed dust were significantly different(P<0.05).Conclusion The detection of Zn,Mn,Sn,and other metals in BALF can provide reference basis for the etiological diagnosis of pneumoconiosis and provide a new idea for the diagnostic method of pneumoconiosis.

关 键 词：尘肺 支气管肺泡灌洗液 诊断 金属 病因学 

分 类 号：R135.2[医药卫生—劳动卫生]