【摘要】 目的探讨血清中白细胞介素-18(IL-18)及其受体(IL-18R)水平在煤工尘肺(CWP)中的变化及意义。方法采用酶联免疫吸附测定法检测134例CWP患者(CWP组)和68例矽肺患者(矽肺组),具有与CWP组相同接尘条件的57例0+矿工(0+组)和64例健康井下接尘矿工(接尘对照组),50例非接尘井上健康人员(正常对照组)血清中IL-18及IL-18R含量,并根据CWP期别及有无合并症、并发症进行分析。结果与正常对照组比较,接尘对照组血清IL-18水平明显降低(P<0.01);CWP组血清IL-18水平显著高于接尘对照组,IL-18R水平显著高于正常对照、接尘对照和0+组(P<0.01);CWP并发肺结核组血清IL-18R水平显著高于单纯CWP组(P<0.01);与Ⅰ期CWP患者比较,Ⅱ期+Ⅲ期CWP患者血清IL-18R水平明显增高,Ⅰ期矽肺患者血清IL-18和IL-18R水平也均明显增高(均P<0.05);而不同接尘年限CWP和矽肺患者血清IL-18和IL-18R水平比较,差异均无显著性(均P>0.05)。CWP组血清IL-18和IL-18R呈正相关(r=0.230,P<0.01),其他各组两者均无相关性。结论IL-18和IL-18R共同参与CWP的发生发展过程,且可能有助于早期CWP病理分型;IL-18R可能预示CWP的严重程度和病情进展。更多还原

【Abstract】 Objective To explore the changes and their significance of interleukin-18(IL-18) and IL-18 receptor (IL-18R) levels in serum of coal worker’s pneumoconiosis (CWP).Methods Serum levels of IL-18 and IL-18R were determined in 134 cases of CWP (CWP group),68 cases of silicosis (silicosis group),57 cases of 0+ miner (0+ group),64 cases of healthy miner (dust exposed control group) and 50 cases of healthy control above the mine (control group) by a enzyme-linked immunosorbent assay,and were further evaluated based on the stages and complication in CWP group.Results In comparison with the control group,serum level of IL-18 in dust exposed control group was significantly lower (P<0.01).The results also showed that serum level of IL-18 in CWP group was significantly higher than that in dust exposed control group,and that serum level of IL-18R in CWP group was significantly higher than those in other groups (P<0.01).Serum level of IL-18R in CWP with pulmonary tuberculosis was significantly higher than that in CWP simply (P<0.01).In comparison with CWP stageⅠ,serum levels of IL-18R in CWP stage Ⅱ and stage Ⅲ were significantly higher,and serum levels of IL-18 and IL-18R in silicosis stageⅠ were also significantly higher (all P<0.05).There were no significant differences in serum levels of IL-18 and IL-18R between CWP and silicosis groups with different dust exposure periods (all P>0.05).There was a positive correlation between serum levels of IL-18 and IL-18R in CWP (r=0.230,P<0.01).Conclusion IL-18 and IL-18R could concomitantly participate in the occurrence and development of CWP,and they might contribute to pathologic typing of CWP in the early stage.IL-18R could indicate the serious extent and development of CWP.更多还原