CAJ | 학술논문

目的　探讨煤尘职业接触者和早期煤工尘肺患者支气管肺泡灌洗液(BALF)中细胞因子含量改变的特点及意义。方法　采煤工23人，按X线胸片诊断为煤尘接触组(接尘组)、煤工尘肺0+和Ⅰ期组；健康农民7人为对照组。经纤支镜做支气管肺泡灌洗，收集BALF，用酶联免疫吸附法 (ELISA)测定肺泡表面活性蛋白-A(SP-A)及肿瘤坏死因子(TNF-α)含量。结果　接尘组BALF中SP-A含量为(6 528.2±1 872.0)ng/ml，TNF-α含量为(8.23±1. 61)U/ml，均明显高于对照组［(1 050.1±912.2)ng/ml及(5.17±0.89)U/ml］，差异有显著性(P<0.01) ；且随煤工尘肺期别进展，SP-A及TNF-α含量降低，SP-A及TNF-α含量变化与煤工尘肺病变严重性之间呈负相关(前者r=-0.64,P<0.01；后者r=-0.45,P<0 .05)。结论　BALF中SP-A和TNF-α含量升高可能是煤尘接触的效应指标。
목적　탐토매진직업접촉자화조기매공진 폐환자지기관폐포관세액(BALF)중세포인자함량개변적특점급의의。방법　채매공23인，안X선흉편진단위매진접촉조(접진조)、매공진폐0+화Ⅰ기조；건강농민7인위대조조。경섬지경주지기관폐포관세，수집BALF，용매련면역흡부법 (ELISA)측정폐포표면활성단백-A(SP-A)급종류배사인자(TNF-α)함량。결과 　접 진조BALF중SP-A함량위(6 528.2±1 872.0)ng/ml，TNF-α함량위(8.23±1. 61)U/ml，균명현고우대조조［(1 050.1±912.2)ng/ml급(5.17±0.89)U/ml］，차 이유현저성(P<0.01) ；차수매공진폐기별진전，SP-A급TNF-α함량강저，SP-A급TNF-α함량변화여매공진폐 병변엄중성지간정부상관(전자r=-0.64,P<0.01；후자r=-0.45,P<0 .05)。결론　BALF중SP-A화TNF-α함량승고가능시매진접촉적효응 지표。
Objective　To explore the feature and signif icance of releasing cytokines from alveolar macrophages and type Ⅱ cells in coa l miners after exposure to coal dust or with early pneumoconiosis. Methods　23 coal miners were selected and divided into 2 groups according to their X-ray expressions,i.e. exposure to coal dust group,0 + and Ⅰ stage group,and 7 healthy smoking farmers as control group .BALF was collected with fibrobronchoendoscope,then the concentrations of surfac e protein-A of alveoli(SP-A) and tumor necrosis factor-α(TNF-α) in the BAL F were measured with ELISA. Results　The me an value of SP-A was (6 528.2±1 872.0)ng/ml,and TNF-α was (8.23±1.61)U/ml in the exposure group,while those in control were (1 050.1±912.2)ng/ml and (5. 17±0.89)U/ml,respectively.There were statistical differences of the concentrati ons of SP-A and TNF-α between the two groups(P<0.01).Moreover,the concent rations of SP-A and TNF-α showed a decreasing trend with the development of p neumoconiosis stage(r=-0.64,P<0.01；r=-0.45,P<0.05,respectively) . Conclusion　The increasing concentrations of SP-A and T NF-α in BALF may be effective markers for diagnosing coal dust exposure.