CAJ | 학술논문

目的：探讨燃煤型砷中毒患者血清 C 反应蛋白（CRP）与肺病理损害之间的关系。方法对22例慢性燃煤型砷中毒患者分别行血清 CRP 检测和肺活检术，分析血清 CRP 水平与患者燃用高砷煤时间及肺组织学检测结果之间的关系。结果患者血清 CRP 检测结果为（59.4±3.5）mg/ L，与正常人群相比显著升高（P <0.01）；血清 CRP 水平与燃用高砷煤时间呈显著正相关（r =0.708，P <0.01）。肺组织病理学改变以肺间质纤维化、炎性细胞浸润及两者并存为其主要特征，3种病变患者间血清 CRP 水平无统计学差异（P >0.05），但分别高于正常人群参考值上限（30 mg/ L）的1.83、2.15和1.92倍（P <0.01）。结论血清 CRP 水平与燃煤型砷污染所致肺损害具有一定关联性；长期吸入毒性较高的三价砷为肺组织损害的直接原因，由此产生的炎性反应参与并加重肺组织损害过程；动态监测血清 CRP 变化，对评估燃煤型砷中毒患者肺损害程度及干预效果具有临床意义。
목적：탐토연매형신중독환자혈청 C 반응단백（CRP）여폐병리손해지간적관계。방법대22례만성연매형신중독환자분별행혈청 CRP 검측화폐활검술，분석혈청 CRP 수평여환자연용고신매시간급폐조직학검측결과지간적관계。결과환자혈청 CRP 검측결과위（59.4±3.5）mg/ L，여정상인군상비현저승고（P <0.01）；혈청 CRP 수평여연용고신매시간정현저정상관（r =0.708，P <0.01）。폐조직병이학개변이폐간질섬유화、염성세포침윤급량자병존위기주요특정，3충병변환자간혈청 CRP 수평무통계학차이（P >0.05），단분별고우정상인군삼고치상한（30 mg/ L）적1.83、2.15화1.92배（P <0.01）。결론혈청 CRP 수평여연매형신오염소치폐손해구유일정관련성；장기흡입독성교고적삼개신위폐조직손해적직접원인，유차산생적염성반응삼여병가중폐조직손해과정；동태감측혈청 CRP 변화，대평고연매형신중독환자폐손해정도급간예효과구유림상의의。
Objective To research the correlation of serum C-reactive protein(CRP)with lung impairment of patients with coal-arsenic poisoning. Methods Serum CRP examination and lung biopsy were carried out for 22 patients with chronic coal-arsenic poisoning,respectively,so as to analyze the correlation of the level of serum CRP with the time using high-arsenic coal and the lung tissue examination results. Results The level of serum CRP of these patients was(59. 4 ± 3. 5)mg/ L,which was significantly higher than that of the normal people(P < 0. 01);the level of serum CRP was positively correlated with the time using high-arsenic coal(r = 0. 708,P < 0. 01). The pathological changes of lung tissues were featured with pulmonary interstitial fibrosis and inflammatory cell infiltration or both,and the levels of serum CRP among the patients with any one of the above pathological changes had no significant difference(P > 0. 05),while it was higher than the reference limit of the normal people(30 mg/ L)by 1. 83,2. 15 and 1. 92 times(P <0. 01). Conclusion There is a certain correlation of the level of serum CRP with lung impairment caused by coal-arsenic pollution;the direct cause to lung impairment is long-term inhalation of high-toxicity trivalent arsenic,which results in inflammatory reaction and takes part in the exacerbation of the lung impairment;it is significant clinically to monitor dynamically the changes of serum CRP for evaluation of the degree of lung impairment caused by coal-arsenic poisoning and the intervention effects.