Studies About The Relation Between Cellular Immune Level Of Silicosis Patients And Lung Function.

PurposeIn our courtry,silicosis is the most serious occupational disease,it has a highmorbidity nate,with a tendency to rise in recent years.Mary factors such as, lessprecaution against occupational disease, from the factory, simple and crudeequipments, bad working conditions must have something to do with it. Silicosis issystemic disease with obciously extensive fibrosis in the lung after long time in hale offree silicon dioxide dust. Pulmonary tuberculosis is the most commomcomplication, the higher stage of silicosis, the higher morbidity of tuberculosis. Inhuman, bodies, the main immune mechanism against tuberculosis is cellularimmunity, humoral immunity has less impact on mycobacterium tuberculosis. So wecan see the change of cellular immunity in humman bodies may has an intensiverelationship with occurance of tuberculosis for silicosis patients. For COPDpatients'number of CD8 cellsincreases significantly in peripheral airways. it has somerelation with airflow vestriction. There is no reports in an abroad on relation betweenCD8 cells and pulmonary function of silicosis patiens. In this experiment, we testseparately cellular immunity level and pulmonary function of silicosis patiens andhealthy people, observe cellular immunity level and pulmonary function ofⅠ,Ⅱ,Ⅲstage silicosis patients, then oliscuss the relation between them.MethodChoose 30 retired persons whose health examination are normal in ShenYangoccupational disease hospital, with no dust and other toxicants contact history, and age beween 60 to 75 to be healthy group. Choose 50 silicosis patients in ShenYangoccupational disease hospital to be silicosis group, age between 60 to 75 whose diseasediagnoseal according to country silicosis Diagnostic Standard (GBZ70-2002).Ⅰstage:30 persons,Ⅱstage:12 persons;Ⅲstage :8 persons. Test lymphocytesubgroup with flow cytometry (FCM) instrument; evaluate large and small airwayfunction by testing pulmonary function.ResultsMake comparison about CD4 lymphocyte, CD8 lymphocyte and ratio of CD4 toCD8 of silicosis patients:Ⅰstage:30 persons,Ⅱstage:12 persons;Ⅲstage :8persons, sum to 50 persons and 30 persons in healthy group, CD4 lymphocytepercentage decreases significantly compared with healthy group. CD8 lymphocytepercentage increases significantly compared with healthy group, and ratio of CD4 toCD8 decreases significantly. Difference of each group is significant, p＜0.05.With theincrease of silicosis stages. CD4 lymphocyte percentage increases gradually. There isno significant difference among the 3 stage groups (p＜0.005). Make comparison aboutpulmonary function among the 3 stage groups. FVC, FEV1, FEV1% and V75% all canreflex ventilation function of large airways. FVC＞80% estimuate number isnormal. FEV1＞80% estimuate number is normal. Normal FEV1%＞80%, normalV75%＞70%.Ⅰstage in silicosis group, FEV1% and V75% numbers are in normallimits, it means large airway function is normal, whileⅡ,Ⅲstage in silicosisgroup, FEV1% and V75% numbers are lower significant difference withⅠstage(p＜0.05), but there is no significant difference betweenⅡandⅢstagegroups(p＞0.05). V50%, V25% both can reflex ventilation function of smallairway. Normal V50%＞70%, normal V25%＞70%. In all theⅠ,Ⅱ,Ⅲstage, V50% andV25% numbers are both lower than normal limit numbers, it shows that patients ofthe 3 three groups have vertilation dysfunction in their small airways. Correlationanalysis of CD4 lymphocyte percentage, CD8 lymphocyte percentage, ratio of CD4 toCD8 and pulmonary function according to the two variable quantities comply with bivariate normal distribution, presults of CD4 percentage, CD8 percentage ratio of CD4to CD8, FEV1,V50% and V25% analized by related modulus formula calculation andstraight line correlation analysis show that:V50 has a negative relation with CD8percentage (r=-0.456,p＜0.01), V50 has a positive relation with CD4 percentage(r=0.448,p＜0.01), V50 has a positive relation with CD4/CD8(r=0.492,p＜0.01);V25%has a negative relation with CD8 (r=-0.571,p＜0.01),V25% has a positive relation withCD4(r=0.537,p＜0.01),V25 has a positive relation with CD4/CD8 (r=0.535,p＜0.01).ResultsCD4 percentage ratio of CD4 to CD8 of silicosis patients decrease significantlycompare with healthy group,while CD8 percentage increases significantly, it showsthat patients' cellular immunity level decreases obviously, which we can speculate hassomething to do with the increase of pulmonary tuberculosis morbidity; With theincrease of pulmonary tuberculosis morbidity; With the increase of silicosis stagespulmonary functions indexes show a decrease tendency. Peripheral T lymphocytesubgroups of silicosis patients have certain influence to pulmonary function, CD8 Tlymphocyte has negative effect on ventilation function of small airway.