不同分期煤工尘肺病例肺功能与炎症因子的相关性分析  

Correlation analysis of lung function and inflammatory factors in patients with coal workers'pneumoconiosis at different stages

作　　者：夏伟 何平 XIA Wei;HE Ping(School of Medicine,Shihezi University,Shihezi,Xinjiang 832000,China;不详)

机构地区：[1]石河子大学医学院预防医学系,新疆石河子832000 [2]新疆维吾尔自治区第三人民医院,乌鲁木齐830000

出　　处：《疾病预防控制通报》2023年第3期6-9,20,共5页Bulletin of Disease Control & Prevention(China)

基　　金：新疆维吾尔自治区科技厅自然科学基金面上项目(2021D01A166)。

摘　　要：目的了解煤工尘肺病例肺功能与炎症因子的相关情况,为临床诊断、治疗及发病机制研究提供依据。方法采用病例对照研究,纳入2020年1月—2023年1月由新疆维吾尔自治区第三人民医院诊断为职业性煤工尘肺的病例及无尘肺病者为研究对象,病例分为煤工尘肺Ⅰ期组、煤工尘肺Ⅱ期组和煤工尘肺Ⅲ期组,无尘肺病者为对照组;开展肺功能检测并采用ELISA法测定血清中炎症因子(IL-18和IL-1β)水平,并采用Pearson相关性分析二者之间的关系;以多因素有序Logistic回归分析影响因素。结果142名研究对象均为男性,其中煤工尘肺Ⅰ期77例、煤工尘肺Ⅱ期10例、煤工尘肺Ⅲ期6例、无尘肺病49人。煤工尘肺Ⅲ期组IL-18和IL-1β水平均高于其他组(P<0.05),煤工尘肺Ⅱ期组DLCO%和DLCO均低于对照组和煤工尘肺Ι期组(P<0.05),煤工尘肺Ⅲ期组FEV1、FEV1%和MEF25(F=3.766,P=0.012)均低于煤工尘肺Ⅱ期组(P<0.05),煤工尘肺Ⅲ期FEV1/FVC低于其他3组(P<0.05);DLCO%与IL-18水平呈正相关(r=0.187),FEV1(r=-0.174)、PEF(r=-0.118)和MEF50(r=-0.174)与IL-1β水平呈负相关。多因素有序Logistic回归分析结果显示IL-1β是煤工尘肺的独立危险因素(OR=4.928,95%CI:2.050~11.846)。结论煤工尘肺分期越高,炎症因子IL-18和IL-1β水平越高,并且IL-1β是煤工尘肺患病的独立危险因素。Objective To understand the correlation between lung function and inflammatory factors in the patients with coal workers'pneumoconiosis(CWP),and provide basis for clinical diagnosis,treatment and pathogenesis.Methods The case-control study was used in this study.The patients diagnosed with occupational CWP and without CWP in the third people's hospital of Xinjiang Uygur Autonomous Region were included in the study from January 2020 to January 2023.The patients were divided into stageⅠof CWP group,stageⅡgroup and stageⅢgroup,and the person without CWP were included as control group.The pulmonary function was tested,and IL-18 and IL-1βlevel were detected in serum with ELISA method.The relation between inflammatory factors and lung function was analyzed by Pearson correlation analysis.The influencing factors were analyzed with multivariate ordered logistic regression.Results All study subjects(142 cases)were the male,included 77 cases at stageⅠof CWP,10 cases at stageⅡof CWP,6 cases at stageⅢof CWP,and 49 persons without CWP.The levels of IL-18 and IL-1βof CWP stageⅢgroup were higher than other groups(P<0.05),and the DLCO%and DLCO in stageⅡof CWP were lower than stageΙof CWP group and control group(P<0.05).The FEV1,FEV1%and MEF25 of stageⅢgroup were lower than that of stageⅡgroup(P<0.05),and the FEV1/FVC of stageⅢgroup was lower than that of other three groups(P<0.05).It was showed positive correlation between DLCO%and IL-18 level(r=0.187),and showed negative correlation between IL-1βlevel and FEV1(r=−0.174),PEF(r=−0.118),MEF50(r=−0.174).The result of multivariate ordered logistic regression analysis showed the IL-1βwas the independent risk factor of CWP(OR=4.928,95%CI:2.050-11.846).Conclusions With the increase of CWP stage,the levels of inflammatory factors of IL-18 and IL-1βalso increase,and the IL-1βis the independent risk factor of CWP.

关 键 词：煤工尘肺 IL-1Β IL-18 肺功能 

分 类 号：R135.2[医药卫生—劳动卫生]