煤工尘肺患病危险因素及外周血中细胞焦亡的机制研究  

Study on the risk factors of coal workers'pneumoconiosis and the mechanism of pyroptosis in peripheral blood

作　　者：夏伟 薛茂强 杨成新 单蕾 牛强[1] 何平 Xia Wei;Xue Maoqiang;Yang Chengxin;Shan Lei;Niu Qiang;He Ping(Medical College,Shihezi University,Shihezi 832000,China;Office of Occupational Health Quality Control,the Third People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830091,China)

机构地区：[1]石河子大学医学院,石河子832000 [2]新疆维吾尔自治区第三人民医院职业卫生质量管理办公室,乌鲁木齐830091

出　　处：《中华劳动卫生职业病杂志》2024年第7期510-516,共7页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：新疆维吾尔自治区自然科学基金面上项目(2021D01A166);"天山英才"医药卫生高层次人才培养计划-领军人才(TSYC202301A088)。

摘　　要：目的探索煤工尘肺患病的危险因素,揭示细胞焦亡在煤工尘肺患者外周血中的分子机制,为疾病的治疗提供新的策略和潜在的诊断生物标志物。方法将2020年1月1日至2022年12月31日在新疆维吾尔自治区第三人民医院进行煤工尘肺诊断的疑似职业病劳动者纳入研究,其中煤工尘肺壹期患者77例、贰期患者10例、叁期患者6例,对照组为无尘肺病劳动者(49例)。收集研究对象的一般信息,采集血样测定血常规和血生化结果,测量血浆中白细胞介素(IL)-1β和IL-18水平。结合临床检查结果,进行多因素有序logistic回归分析,评估煤工尘肺的影响因素。同时检测血细胞中细胞焦亡相关蛋白的表达情况,揭示煤工尘肺发病的分子机制。结果142名研究对象均为男性,年龄为(51.65±6.31)岁,工龄为(15.94±9.38)年,各组研究对象的烟龄(F=4.95,P=0.003)和午休分布(H=8.84,P=0.031)差异均有统计学意义。煤工尘肺壹期患者的血红蛋白含量高于煤工尘肺贰期,煤工尘肺叁期的中性粒细胞百分比高于其他3组(P<0.05)。煤工尘肺壹期患者的总胆红素水平和间接胆红素水平高于对照组,而煤工尘肺贰期的红细胞沉降率高于其他3组(P<0.05);煤工尘肺叁期的IL-18和IL-1β水平高于其他3组(P<0.05)。多因素有序logistic回归分析结果显示,烟龄(OR=1.03,95%CI:1.00~1.06)和IL-1β水平(OR=4.61,95%CI:1.59~13.32)是煤工尘肺的独立危险因素(P<0.05)。与对照组比较,煤工尘肺叁期患者核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、半胱氨酸天冬氨酸蛋白酶1(Caspase-1)、消化道皮肤素D蛋白(GSDMD)、半胱氨酸天冬氨酸蛋白酶4(Caspase-4)等蛋白表达量均明显增高(P<0.05)。结论烟龄是煤工尘肺的危险因素,IL-1β可能是诊断煤工尘肺的潜在生物标志物,且细胞焦亡在煤工尘肺的外周炎症发展中可能发挥作用。ObjectiveTo explore the risk factors of coal workers'pneumoconiosis,reveal the molecular mechanism of pyroptosis in peripheral blood of coal workers'pneumoconiosis patients,and provide new strategies and potential diagnostic biomarkers for the treatment of the disease.MethodsFrom January 1,2020 to December 31,2022,workers with suspected occupational diseases who were diagnosed with coal workers'pneumoconiosis in the Third People's Hospital of Xinjiang Uygur Autonomous Region were included in the study,including 77 patients with coal workers'pneumoconiosis stageⅠ,10 patients with stageⅡ,6 patients with stageⅢ,and 49 workers with dust-free lung disease as the control group.General information of the subjects was collected,blood samples were collected for routine blood and blood biochemical results,and plasma levels of interleukin(IL)-1βand IL-18 were measured.Combined with the results of clinical examination,multi-factor ordered logistic regression analysis was carried out to evaluate the influencing factors of coal workers'pneumoconiosis.At the same time,the expression of pyroptosis related proteins in blood cells was detected to reveal the molecular mechanism of coal workers'pneumoconiosis.ResultsAll 142 subjects were male,with an average age of(51.65±6.31)years old and an average working age of(15.94±9.38)years.There were significant differences in smoking age(F=4.95,P=0.003)and lunch break distribution(H=8.84,P=0.031)among all groups.The hemoglobin content of stageⅠpatients was higher than that of stageⅡpatients,and the neutrophil percentage of stageⅢpatients was higher than that of the other 3 groups(P<0.05).The levels of total bilirubin and indirect bilirubin in stageⅠpatients were higher than those in control group,while the erythrocyte sedimentation rate in stageⅡpatients was higher than that in the other 3 groups(P<0.05).The levels of IL-18 and IL-1βin stageⅢof coal workers'pneumoconiosis were higher than those in the other 3 groups(P<0.05).Multiple logistic regression analysis showed

关 键 词：尘肺 煤工尘肺 危险因素 白细胞介素1Β 回归分析 经典细胞焦亡 非经典细胞焦亡 

分 类 号：R135.2[医药卫生—劳动卫生]