摘要
目的通过检测尘肺病患者全肺大容量肺灌洗液中金属及类金属元素的成分和浓度，分析其特点，探索尘肺病患者大容量全肺灌洗样品的采集、处理方法。方法收集3例尘肺病患者术前血清及尿液和大容量肺灌洗分段灌洗液样品，后者按照大容量肺灌洗术4次加压通气及5次负压引流的顺序，对左右两肺全部灌洗液分别进行分段收集原始混合液，每段次收集10 ml混合液后，其余全部离心，采集所有沉淀样品和10 ml上清液，用电感耦合等离子体质谱仪（ICP-MS）测量样品中各类金属及类金属元素。结果3例尘肺病患者单侧肺灌洗液体积（10 758.3±1 518）ml，单侧肺平均回收率89.7%。两肺离心沉淀物干重平均0.292 g，右肺稍高于左肺。样品可检出元素包括Ba、Sr、Ca、Mg、Mn、Fe、Cu、Zn、K、Na、Se、Si、U共13种，各元素浓度不呈正态分布。经非参数Kruskal-Wallis检验，除Cu、Se、U外，其余10种元素在上清液、混合液和沉淀物中的浓度均差异有统计学意义（P〈0.05），其中Na、K和Ba在上清液中的浓度较高，其余金属元素在沉淀中的浓度较高。右肺灌洗液中各元素浓度稍高于左肺灌洗液中元素浓度，差异无统计学意义（P〉0.05）。加压前后沉淀样品中各元素浓度差异有统计学意义（P〈0.05）。K、Ca、Mg、Si、Se浓度在血清、尿、上清液和沉淀物中有较好的相关性，其中rSi血清-沉淀=0.676，rSi尿-沉淀=0.524。结论沉淀样品中各元素浓度较其他两种样品更稳定；全肺灌洗液金属及类金属元素检测分析时可采集单侧肺进行研究；可将第一次加压后作为沉淀样品最佳采样时段。
Objective To detect of the components and concentration of the metals and metalloids in the lavage fluid of whole-lung lavage （WLL） of the cases of pneumoconiosis, and analyze the characteristics, and explore the method to sample and process the samples of bronchoalveolar lavage fluid （BAL） .Methods The samples of urine and serum of three cases of pneumoconiosis were collected before WLL, and the samples of BAL were collected during the WLL from the left and right lungs according to the sequence of four pressured gas flow and five negative pressure drainage. Each of 10ml original samples of WLL was collected firstly, and the left was centrifuged to acquire all the sediment samples and each of 10 ml samples from the centrifuge clear liquids, The components and concentration of the metals and metalloids in the samples were measured by Inductively Coupled Plasma mass spectrometer （ICP-MS） .Results The average volume of BAL from unilat-eral lung for 3 patients was 10 758.3±1518 ml, and the average recovery rate was 89.7%. The average dry weight of sediment samples of BAL of three cases of pneumoconiosis was 0.292 gram with the right lung sam-ples slightly higher than the left lung samples. The detectable elements from the samples included Barium （Ba） , Strontium （Sr） , Calcium （Ca） , Magnesium （Mg） , Manganum （Mn） , Ferrum （Fe） , Cuprum （Cu） , Zinc （Zn） , Kalium （K） , Natrium （Na） , Selenium （Se） , Silicon （Si） and Uranium （U） . Each of concentration dis-tributions of these elements were not normal. Except for Cuprum, Selenium and Uranium, the concentrations of the other ten elements in the supernatant samples, mixture samples and sediments samples were statistical-ly different with the nonparametric test of Kruskal-Wallis. The concentrations of Natrium, Kalium and Barium in supernatant samples were higher, while the others in precipitation samples were higher. The concentration of elements in the sample from the right lung was slightly higher than that from the left lung, but there was no statistically significant difference （P〉0.05） . There were statistical difference in term of element concentration of precipitates samples before and after pressured gas flow （P〈0.05） . The concentration of K、Ca、Mg、Si and Se in se-rum, urine, supernatant and sediment samples had a good correlation. The correlation coefficient of Silicon between serum and precipitation was 0.676 and that between urine and precipitation was 0.524.Conclusion The concentra-tions of the metals and metalloid in sediment samples were more stable than that of supernatant and mixture samples. The sampling of one-side lung lavage fluid was representative in the detection of metals and metalloid in the BAL. It was the best time for sampling sediment from the BAL after the first pressured gas flow among the WLL.
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
2017年第11期832-836,共5页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
尘肺
支气管肺泡灌洗液
金属
Pneumoconiosis
Bronchoalveolar lavage fluid
Metallic
