摘要目的 分析金属粉尘肺沉着病患者诱导痰炎症细胞和白细胞介素(IL)-8水平的变化,探讨患者气道炎症的变化特点.方法 研究对象分为正常对照组20例,哮喘组20例,金属粉尘肺沉着病患者25例(均为电焊工),按诱导痰方法收集痰液,进行细胞分类及计数,测定诱导痰炎症细胞和IL-8水平的变化.结果 金属粉尘肺沉着病组患者的肺功能均在正常范围.金属粉尘肺沉着病组用力肺活量(FVC)为(4.1±1.2)L,与正常对照组[FVC(4.3±0.9)L]比较,差异无统计学意义(P＞0.05).金属粉尘肺沉着病组第1秒用力呼气容积(FEV1.0)为[(2.9±0.9)L],FEV1.0/FVC为71.9％±5.4％,较正常对照组[FEV1.0:(3.2±0.7)L、FEV1.0/FVC:79.2％±9.9％]明显减低,明显高于哮喘组[FEV1.0:(2.5±0.8)L及FEV1.0/FVC:68.7％±6.1％],差异均有统计学意义(P＜0.05).金属粉尘肺沉着病组诱导痰中性细胞百分比为(43.9％±7.6％),较哮喘组及正常对照组(41.3％±7.1％、39.8％±6.9％)增高,嗜酸性粒细胞和淋巴细胞百分比分别为0.3％±0.1％、2.0±0.4％,较哮喘组(2.8％±0.3％、4.7％±0.6％)明显降低,差异有统计学意义(P＜0.05).金属粉尘肺沉着病组诱导痰上清液中的IL-8浓度为(914.7±24.3) pg/ml,明显高于哮喘患者组[(747.9±16.8) pg/ml]和正常对照组[(405.4±13.7) pg/ml],差异有统计学意义(P＜0.05).结论 铁及其化合物粉尘长期吸入后可引起气道炎症反应,致气道功能减退,巨噬细胞及IL-8在发病中可能起到重要作用.

abstractsObjective To study the airway inflammation feature difference in the patients with occupational pulmonary thesaurosis induced by iron.Methods Induced sputum samples were obtained from 20 healthy men,20 patients with stable asthma,25 patients with occupational pulmonary thesaurosis induced by iron.Differential cell counts in induced sputum were examined.The levels of supematant IL-8 were measured by ELISA.Results The pulmonary function result was normal in the patients with pulmonary thesaurosis.,their FVC (4.1 ± 1.2) L was similar to FVC (4.3±0.9) L in mal group;but their FEV1.0(2.9±0.9) L、FEV1/FVC (71.9％±5.4％) were lower than normal group's FEV1.0 (3.2±0.7 L) 、FEV1.0/FVC (79.2％±9.9％),and were hirher than asthma group's FEV1 (2.5±0.8) L and FEV1.0/FVC (68.7％±6.1％).In induced sputum,macrophages percentage in patients with pulmonary thesaurosis (54.3％±9.7％) was higher than asthma group and normal group (48.4±6.4,51.9±7.3,P＜0.05),neutrophils percentage in patients with pulmonary thesaurosis group (43.9％±7.6％) was higher than asthma group and normal group (41.3％±7.1％,39.8％±6.9％,P＜0.05),eosinophils percentage in patients with pulmonary thesaurosis group (0.3％±0.1％) was lower than asthma group (2.8±0.3,P＜0.05),lymphocytes percentage in patients with pulmonary thesaurosis group (2.0％±0.4％) was lower than asthma group (4.7±0.6,P＜0.05);the sputum levels of IL-8 in patients with pulmonary thesaurosis group(914.7±24.3) pg/ml was higher than asthma group and normal group(747.9％±16.8 pg/ml,(405.4±13.7)pg/ml,P＜0.05).Conclusion Macrophages and IL-8 may play an important role in the pathogenesis of airway inflammation after long-term inhalation of iron and its compounds,the airway function in patients of occupational pulmonary thesaurosis was found damaged.