CAJ | 학술논문

目的探讨尘肺患者血清和支气管肺泡灌洗液(BALF)中白细胞介素(IL)-6、可溶性白细胞介素2受体( sIL-2R)和肿瘤坏死因子(TNF-α)含量及外周血T细胞亚群变化,及其与尘肺分期的相关性.方法将研究对象分为健康对照组(6例),接尘对照组(6例),尘肺组(Ⅰ期尘肺36例、Ⅱ期12例、Ⅲ期10例),ELISA法检测各组血清和BALF中IL-6、sIL-2R和TNF-α含量；流式细胞仪进行T细胞亚群分类.结果与健康对照组和接尘对照组比较,Ⅱ、Ⅲ期尘肺患者血清中IL-6和各期尘肺患者血清中sIL-2R含量明显升高,并与尘肺分期呈高度正相关(r1=0.74,r2=0.81,P＜0.05)；Ⅲ期尘肺患者血清中TNF-α的含量明显低于健康对照组和接尘对照组,并与尘肺分期呈负相关(r=-0.58,P＜0.05).Ⅲ期尘肺患者BALF中IL-6、sIL-2R含量明显增高,TNF-α含量明显下降,差异均有统计学意义(P＜0.05).BALF中IL-6、sIL-2R和TNF-α含量与血清含量呈正相关关系(r1=0.77,r2=0.96,r3=0.88,P＜0.05).Ⅱ、Ⅲ期尘肺患者外周血中CD4+T细胞比例、CD4+/CD8+比对照组明显下降,T细胞亚群变化与尘肺分期无相关关系.结论尘肺患者Th型细胞呈免疫抑制状态,血清和BALF中IL-6、sIL-2R和TNF-α含量与尘肺分期有关.
목적 탐토진폐환자혈청화지기관폐포관세액(BALF)중백세포개소(IL)-6、가용성백세포개소2수체( sIL-2R)화종류배사인자(TNF-α)함량급외주혈T세포아군변화,급기여진폐분기적상관성.방법 장연구대상분위건강대조조(6례),접진대조조(6례),진폐조(Ⅰ기진폐36례、Ⅱ기12례、Ⅲ기10례),ELISA법검측각조혈청화BALF중IL-6、sIL-2R화TNF-α함량；류식세포의진행T세포아군분류.결과 여건강대조조화접진대조조비교,Ⅱ、Ⅲ기진폐환자혈청중IL-6화각기진폐환자혈청중sIL-2R함량명현승고,병여진폐분기정고도정상관(r1=0.74,r2=0.81,P＜0.05)；Ⅲ기진폐환자혈청중TNF-α적함량명현저우건강대조조화접진대조조,병여진폐분기정부상관(r=-0.58,P＜0.05).Ⅲ기진폐환자BALF중IL-6、sIL-2R함량명현증고,TNF-α함량명현하강,차이균유통계학의의(P＜0.05).BALF중IL-6、sIL-2R화TNF-α함량여혈청함량정정상관관계(r1=0.77,r2=0.96,r3=0.88,P＜0.05).Ⅱ、Ⅲ기진폐환자외주혈중CD4+T세포비례、CD4+/CD8+비대조조명현하강,T세포아군변화여진폐분기무상관관계.결론 진폐환자Th형세포정면역억제상태,혈청화BALF중IL-6、sIL-2R화TNF-α함량여진폐분기유관.
Objective To analyze the correlation between the pneumoconiosis severity and the cytokines levels in serum and bronchoalveolar lavage fluid (BALF) or blood T cell subsets.Methods The subjects were divided into five groups:control group (6 cases),group exposed to dusts (6 cases) and 3 pneumoconiosis groups (36 in stage I,12 in stage Ⅱ and 10 in stage Ⅲ).ELISA was used to detect IL-6,sIL-2R and TNF-α levels in serum and BALF.The subsets of blood T cells were classified by flow cytometer.Results As compared with control group and group exposed to dusts,the levels of serum IL-6 and sIL-2R in patients with Ⅱ or Ⅲ stages significandy increased,which were positively correlated with pneumoconiosis stages (r1=0.74,r2=0.81,P＜0.05).The level of serum TNF-α significantly decreased in patients with Ⅲ stages,as compared with control group and group exposed to dusts.There was a negative correlation between serum TNF-α level and pneumoconiosis severity (r=-0.58,P＜0.05 ).There was a positive correlation between the levels of IL-6、sIL-2R and TNF-o in BALF and the levels of IL-6 、sIL-2R and TNF-α in serum (r1=0.77,r2=0.96 and r3=0.88,P＜0.05).The proportion of CD4+T cells and the ratio of CD4+/CD8+ deceased dramatically in patients with Ⅱ and Ⅲ stages.But there was no correlation between these values and disease severity.Conclusion The immune function in Th cell was inhibited.The levels of IL-6,sIL-2R and TNF-α in serum and BALF were associated with the severity of pneumoconiosis.