煤工尘肺患者肺表面活性蛋白A和C与肺功能损害的关系

目的探讨煤工尘肺患者血清中肺表面活性蛋白A（SP—A）和C（SP—C）与肺功能损害的关系，为煤工尘肺标志物的研究提供理论依据。方法选择32例煤工尘肺患者和41例健康体检者作为研究对象，对其血清中SP—A和SP-C进行检测，同时进行呼吸困难分级评定和肺功能检测，测定项目包括通气功能用力肺活量（FVC），1秒钟用力呼气量（FEV．），最大通气量（MVV）]和弥散功能一氧化碳弥散量（DLCO）]，测定结果以实测值占预计值的百分数表示，1秒钟用力呼气量与用力肺活量比值（FEV。％）为实测值。结果32例煤工尘肺患者呼吸困难分级为Ⅲ级14例，Ⅳ级18例。呼吸功能Ⅳ级煤工尘肺患者的FEV1、MVV和DLCO占预计值的百分比分别为（69．38±15．17）％、（65．89±8．14）％、（69．55±7．96）％，明显低于健康对照组（96．35±10．24）％、（94．13±10．38）％和（96．51±11．37）％]，差异均有统计学意义（P均〈0．05）。尘肺组血清中SP—A、SP—C分别为（4．02±1．22）μg／L和（3．58±0．67）ng／L，健康对照组分别为（2．41±0．68）μg／L和（2．31±0．29）ng／L，差异均有统计学意义（t值分别为6．480和9．290，P值分别为0．001和〈0．001）。血清SP-A与尘肺患者接尘工龄、呼吸困难分级、DLCO相关（r值分别为0．124、0．235、-0．352，P值分别为0．042、0．041、0．025），血清SP-C与接尘工龄、呼吸困难分级、FEV，相关（r值分别为0．117、0．288、-0．238，P值分别为0．015、0．037、0．036）。结论煤工尘肺患者血清中SP—A、SP-C与肺功能损伤密切相关，可作为煤尘致肺损伤的候选标志物。

Association between serum levels of SP-A, SP-C and the impairment of lung function in coal workers with pneumoconiosis

Objective To investigate the relationship between serum levels of surfactant protein （SP）- A,SP-C and lung function impairment in coal workers with pneumoconiosis（CWP） in order to provide evidence for the biomarker study of pneumoconiosis. Methods Thirty-two coal workers with pneumoconiosis and 41 healthy controls were included in this study. Serum levels of SP-A and SP-C were measured. Grading assessment of dyspnea and pulmonary function including predicted percentages of FVC, FEV1 , FEV1/FVC, MVV, and DLCO were conducted. Results Among the 32 participants with CWP,the severity of dyspnea was rated as level Ill for 14 and level IV for 18 individuals. The pulmonary function was significantly impaired in CWP patients with level IV dyspnea compared with the healthy controls （ FEV1% predicted ： 69. 38 ± 15.17 ] % vs. 96. 35 ± 10. 24 ] % ; MVV% predicted： 65.89 ± 8. 14 ] % vs. 94. 13± 10. 38 ] % ; DLCO% predicted ： 96. 51±11. 37 ] %. The serum levels of SP-A and SP-C were significantly higher in CWP patients than that in the healthy controls （ SP-A ： 4. 02 ± 1.22 ]μg/L vs. 2. 41 ±0. 68 ] μg/L, t = 6. 480, P = 0.001 ; SP-C ： 3.58 ±0. 67 ] ng/L vs. 2. 31± 0. 29 ] ng/L,t = 9. 290 ,P 〈 0. 001 ）. Serum SP-A and SP-C levels in CWP patients were found to be significantly correlated with exposure to dust, dyspnea severity, FEV1 % predicted and DLCO% predicted. Conclusion Serum SP-A and SP-C levels in CWP patients are closely associated with lung function, suggesting their role as candidate biomarkers for CWP.