摘要
目的探讨矽肺患者血卵泡抑素样蛋白1(FSTL1)、Ⅱ型肺泡细胞表面抗原6(KL-6)、肿瘤坏死因子-α(TNF-α)、可溶性白细胞介素-2受体(sIL-2R)水平变化及其临床意义。方法回顾性选取100例矽肺患者作为矽肺组,依据矽肺程度分为1期(40例)、2期(36例)、3期(24例),同期选取体检中心健康人员30例作为健康组,采用酶联免疫吸附法检测血FSTL1、KL-6、TNF-α、sIL-2R水平。结果矽肺组血浆FSTL1、KL-6、TNF-α、sIL-2R水平明显高于健康组,差异有统计学意义(P<0.05)。在血浆FSTL1、KL-6、TNF-α、sIL-2R水平方面,矽肺组2期、3期患者明显高于1期患者,差异有统计学意义(P<0.05),矽肺组2期、3期患者比较,差异无统计学意义(P>0.05)。ROC分析结果显示,在评估矽肺患者肺纤维化敏感度、特异度、准确度、阳性预测值、阴性预测值方面,FSTL1以>4.80 ng/mL为临界值时分别为64.91%、62.79%、64.00%、69.81%、57.45%,KL-6以>460 U/mL为临界值时分别为61.40%、60.47%、61.00%、67.31%、54.17%,TNF-α以>133 pg/mL为临界值时分别为57.89%、67.44%、62.00%、70.12%、54.72%,sIL-2R水平以>270 U/mL为临界值时分别为63.16%、55.81%、60.00%、65.45%、53.33%,四者联合时,以FSTL1>4.91 ng/mL、KL-6>451 U/mL、TNF-α>128 pg/mL、sIL-2R>285 U/mL为临界值分别为77.19%、72.09%、75.00%、66.67%、91.18%,四者联合时明显高于四者单独时,差异有统计学意义(P<0.05)。结论血浆FSTL1、KL-6、TNF-α、sIL-2R水平与矽肺的发生、发展有关,检测四者水平可作为评估患者肺纤维化病变的重要参考指标,且四者联合具有更高的评估效能,值得临床作进一步推广。
Objective To investigate the expression and significance of serum follicular statin like protein 1 ( FSTL1),Krebs Von den Lungen - 6 ( KL - 6),tumor necrosis factor -α( TNF -α),and soluble interleukin - 2 receptor ( sIL - 2R) levels in silicosis patients. Methods Hundred patients with silicosis patients were selected as sili- cosis group. According to the degree of silicosis,they were divided into Stage 1 ( 40 cases),2 ( 36 cases),and 3 ( 24 ca- ses),while 30 healthy persons were selected as health group. The levels of serum FSTL1,KL - 6,TNF -α and sIL - 2R were assessed by enzyme linked immunosorbent assay. Results The serum FSTL1,KL - 6,TNF -α and sIL - 2R levels of silicosis group were significantly higher than those of health group ( P < 0. 05). The serum levels of FSTL1,KL - 6, TNF -α and sIL - 2R of patients of Stage 2 and 3 were significantly higher than those of Stage 1 ( P < 0. 05). ROC analy- sis showed that the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of FSTL1 in predicting pulmonary fibrosis in silicosis patients were 64. 91%,62. 79%,64. 00%,69. 81% and 57. 45%,respective- ly;of KL - 6 were 61. 40%,60. 47%,61. 00%,67. 31% and 54. 17%,respectively;of TNF -α were 57. 89%, 67. 44%,62. 00%,70. 12% and 54. 72%,respectively;and of IL - 2R were 63. 16%,55. 81%,60. 00%,65. 45% and 53. 33%,respectively. When using the 4 indexes as combined predictor,they were 77. 19%,72. 09%,75. 00%, 66. 67% and 91. 18%,respectively;with significant superior predicting value than using each single index alone ( P < 0. 05). Conclusion The serum FSTL1,KL - 6,TNF -α and sIL - 2R are correlated to the development of silicosis. The test of four indexes can be used as an important reference index in diagnosis of the pulmonary fibrosis. The combina- tion of the 4 indexes has a higher evaluation efficiency.
作者
李瑞文
黄明
李聪
吴奇峰
赖关朝
LI Rui - wen;HUANG Ming;LI Cong;WU Qi - feng;LAI Guan - chao(Medical Laboratory,Guangdong Occupational Disease Prevention Hospital,Guangzhou 510300,Guangdong,China)
出处
《广东医学》
CAS
2019年第10期1396-1400,共5页
Guangdong Medical Journal
基金
广东省医学科研基金立项项目(编号:B2016056)
广东省职业病防治重点实验室(编号:2017B030314152)
