【摘要】 目的 探索矽肺患者血清中活性维生素D[1,25（OH）₂D₃]、克拉拉细胞分泌蛋白（CC16）含量临床价值。方法 以本院89例矽肺患者为矽肺组，以同期无粉尘接触健康检查者60例为对照组，检测2组肺功能指标及血清中1,25（OH）₂D₃、CC16含量，比较两组血清中1,25（OH）₂D₃、CC16含量的差异，探讨二者与肺功能的相关性。结果 矽肺壹期、贰期、叁期组血清中1,25（OH）₂D₃含量分别为（16.14±5.35）、（12.44±4.21）、（10.01±3.68）ng/ml均低于对照组（21.92±3.73）ng/ml（t=6.603,10.355,10.784；均P<0.01）；矽肺贰、叁期组1,25（OH）₂D₃含量均低于壹期组（t=3.092,4.008；均P<0.05）。矽肺壹、贰、叁期组血清中CC16水平分别为（12.70±1.90）、（11.04±2.23）、（11.33±1.47）ng/ml均低于对照组（17.92±1.97） ng/ml（t=13.900,14.461,11.750；均P<0.01）；贰、叁期矽肺组CC16水平低于壹期组（t=3.410,2.484；均P<0.05）。随着尘龄增加，血清中1,25（OH）₂D₃、CC16水平均降低，二者呈正相关（r=0.262,P<0.05）。矽肺组血清中1,25（OH）₂D₃含量与FEV₁、FEV₁/FVC%均呈正相关（r=0.290、0.230；均P<0.05），血清中CC16含量与FEV₁呈正相关（r=0.235,P<0.05）。结论 矽肺患者血清中1,25（OH）₂D₃、CC16含量均降低且与肺功能相关，二者可能具有协同作用，共同参与了矽肺发生、发展，检测二者对矽肺辅助诊断和预后判断有一定参考作用。更多还原

【Abstract】 Objective To investigate the clinical value of serum active vitamin D[1,25（OH）₂D₃]and Clara cell secreted protein（CC16）in silicosis patients.Methods A total of 89 patients with silicosis in our hospital were selected as the silicosis group.Sixty cases of health examination clients without dust exposure were selected as the control group at the same time.Lung function indicators were examined in the two groups,and the contents of 1,25（OH）₂D₃and CC16 in serum were detected.The differences of the contents of 1,25（OH）₂D₃and CC16 in serum of the two groups were compared,and the correlations between the content of 1,25（OH）₂D₃and CC16 level in serum and lung function indicators were analyzed,respectively.Results The contents of serum 1,25（OH）₂D₃in the first and second and third stage of silicosis group were（16.14±5.35）,（12.44±4.21）,（10.01±3.68）ng/ml,respectively,which were lower than those in healthy control group（21.92±3.73）ng/ml（t=6.603,10.355,10.784;all P<0.01）.The levels of serum1,25（OH）₂D₃in the patients with silicosis in the second and third stage groups were lower than those in the first stage group,respectively（t=3.092,4.008;all P<0.05）.The contents of serum CC16 in the first and second and third stage of silicosis group were（12.70±1.90）,（11.04±2.23）,（11.33±1.47）ng/ml,respectively,which were lower than those in healthy control group（17.92±1.97）ng/ml（t=13.900,14.461,11.750;all P<0.01）.The levels of serum CC16 in the second and third stage silicosis group were lower than those in the first stage group,respectively（t=3.410,2.484;all P<0.05）.With the increase of the exposure time of the dust in silicosis patients,the levels of 1,25（OH）₂D₃and CC16 in serum decreased,respectively,and the level of 1,25（OH）₂D₃was positively correlated with CC16 level in serum（r=0.262,P<0.05）.In silicosis group,the levels of serum 1,25（OH）₂D₃were positively correlated with FEV₁and FEV₁/FVC%,respectively（r=0.290,0.230;all P<0.05）,and the level of serum CC16 was positively correlated with FEV₁（r=0.235,P<0.05）.Conclusions The serum levels of1,25（OH）₂D₃and CC16 in patients with silicosis decreased and were correlated with lung function.The two factors may play a synergistic role in the occurrence and development of silicosis,and the combined detection of the two factors may have a certain reference value for the auxiliary diagnosis and prognosis of silicosis.更多还原