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目的探讨煤工尘肺(CWP)患者血清和支气管肺泡灌洗液(BALF)中肿瘤坏死因子-α(TNF-α)在CWP发病过程中的作用与意义。方法采用立意抽样方法,将28例CWP患者根据期别分为CWP壹期组7例、CWP贰期组10例、CWP叁期组11例,分别收集患者血清和BALF,用化学发光法检测其中的TNF-α水平,并对患者进行肺功能检查。结果 CWP患者血清中TNF-α水平与CWP期别呈正相关[Spearman相关系数(rS)=0.843,P<0.01],与1秒率(FEV1/FVC)呈负相关(rS=-0.503,P<0.01)。CWP患者BALF中TNF-α水平与CWP期别呈负相关(rS=-0.654,P<0.01),与FEV1/FVC呈正相关(rS=0.432,P<0.05);CWP患者血清和BALF中TNF-α水平呈负相关(rS=-0.561,P<0.01)。结论 CWP患者血清和BALF中TNF-α水平随着CWP期别的增高呈现不同的变化趋势,且与肺功能的改变有关联;TNF-α可作为评估CWP病情严重程度的参考指标。
Objective To investigate the role of tumor necrosis factor-α (TNF-α) in the pathogenesis of CWP in the serum of patients with CWP and in bronchoalveolar lavage fluid (BALF). Methods 28 cases of CWP patients were divided into seven groups according to the period of CWP Ⅰ group, 10 cases of CWP II group and 11 cases of CWP Ⅲ group according to the intention sampling method. Serum and BALF were collected from patients with CWP and chemiluminescence method TNF-α levels, and patients with pulmonary function tests. Results The level of TNF-α in CWP patients was positively correlated with CWP (Spearman correlation coefficient (rS) = 0.843, P <0.01), and negatively correlated with 1 second rate (FEV1 / FVC) 0.01). The level of TNF-αin BALF of CWP patients was negatively correlated with CWP (rS = -0.654, P <0.01) and positively correlated with FEV1 / FVC (rS = 0.432, α level was negatively correlated (rS = -0.561, P <0.01). CONCLUSIONS: The levels of TNF-α in serum and BALF of CWP patients show different trend with the increase of CWP stage, and are associated with the changes of pulmonary function. TNF-α may be used as a reference index to evaluate the severity of CWP.