大剂量乙酰半胱氨酸对矽肺血清纤维化指标和T淋巴细胞亚群的影响

目的探讨大剂量乙酰半胱氨酸(NAC)对矽肺患者血清中纤维化指标和T淋巴细胞亚群的影响及其意义。方法矽肺患者43例,随机分成2组,其中常规治疗为对照组18例;NAC治疗组25例,在常规治疗的基础上加用NAC口服,每次600 mg,每日3次,疗程3个月。治疗前后用化学发光法测定血清中纤维化指标和T淋巴细胞亚群。结果 NAC组治疗后,血清中铜蓝蛋白(CP)、透明质酸(HA)水平降低,与治疗前及对照组治疗后比较,差异均有统计学意义(P0.05);血清中层黏蛋白(LN)水平降低,与治疗前比较,差异有统计学意义(P0.05);血清中Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PC-Ⅲ)与治疗前及对照组治疗后比较,差异均无统计学意义(P0.05);NAC组治疗后血清中CD3+、CD4+水平明显增加,与治疗前及对照组治疗后比较,差异均有统计学意义(P0.05);血清中CD4+/CD8+明显增加,与治疗前比较,差异有统计学意义(P0.05);血清中CD8+与治疗前及对照组治疗后比较,差异均无统计学意义(P0.05)。结论大剂量NAC治疗矽肺,能抑制肺纤维化进程,并改善患者的免疫状态。

Effect of high dose N-acetylcysteine on serum fibrosis markers and T lymphocyte subsets in patients with silicosis

Objective]To study the effect and significance of high dose N-acetylcysteine(NAC) on serum fibrosis markers and T lymphocyte subsets in patients with silicosis.Methods]43 patients with silicosis were randomly divided into the control group(18 cases) and NAC group(25 cases).The control group was given the routine treatment.On the basis of the routine treatment,the NAC group was treated with 600 mg NAC by oral administration,three times a day for the period of three months.The serum fibrosis markers and T lymphocyte subsets were detected by chemiluminescence before and after treatment.Results]After treatment,the serum levels of ceruloplasmin(CP) and hyaluronic acid(HA) in NAC group had declined,which were significantly lower than those before treatment,meanwhile,were lower than those in the control group after treatment(P<0.05).The serum level of laminin(LN) in NAC group after treatment was significantly lower than that before treatment(P<0.05).There was no significant difference in the serum levels of collagen type Ⅳ(Ⅳ-C) and procollagen type Ⅲ(PC-Ⅲ) between before and after treatment in NAC group,as well as between NAC group and the control group after treatment(P>0.05).After treatment,the serum levels of CD3+ and CD4+ in NAC group had increased obviously,which were significantly higher than those before treatment,meanwhile,were higher than those in the control group after treatment(P<0.05).The serum level of CD4+/CD8+ in NAC group after treatment was significantly higher than that before treatment(P<0.05).There was no significant difference in the serum level of CD8+ between before and after treatment in NAC group,as well as between NAC group and the control group after treatment(P>0.05).Conclusion]High dose NAC can inhibit the process of pulmonary fibrosis and improve the immune state of patients with silicosis.