| Objectives As a typical disease of pneumoconiosis,silicosis is a systemic disease caused by long-term inhalation of silica crystals by dust-exposed workers,which is mainly characterized by pulmonary fibrinization and may lead to other complications.When silica particles through the alveolar macrophage its receptor(MARCO)scavenging receptors are recognized and phagocytic,causing inflammatory response,a variety of products play a role,and eventually form fibrosis.At present,only occupational history and X-ray diagnosis can be relied on,and most of them are found in the late stage,resulting in the delay of the disease course.Therefore,it is urgent to search for early and effective biomarkers to achieve the purpose of early detection.This study aims to investigate the changes in the levels of silicon,TGF-β1,CC16 and TNF-α in the workers exposed to silica dust in an iron mine,so as to provide theoretical basis for early screening and diagnosis of silicosis.Methods A total of 478 medical examinants from an iron mine in Henan were selected as the research subjects.Among them,88 were diagnosed as stage I silicosis according to highk V chest radiograph.At the same time,116 people in the same mining area were selected as the control group who were not engaged in dust-catching operation and had normal physical examination indexes.A total of 274 patients with over 1 year of exposure to silica dust and no diagnosis of silicosis in clinical manifestations and chest radiographs at high k V were selected as the dust exposure group.For the basic information of the population,the method of on-site investigation was adopted,and investigators with unified training were conducted face to face.The behavior and living habits of the research subjects,including drinking,smoking,etc.General information,including age,gender,education level,basic living conditions,working conditions,past medical history,drinking history,silica dust exposure years and other information.Occupational information: detailed inquiries should be made about the age of starting work,the nature of employment,changes in work types,physical activity,exposure to occupational harmful factors,use of protective facilities,etc.Personal and family medical history,such as hypertension,diabetes,asthma,and chronic obstructive pulmonary disease(COPD),were also asked.The height and weight were measured by infrared height and weight measuring instrument.Blood and urine samples were collected: 5m L of morning elbow venous blood was extracted on an empty stomach,placed in a sterile test tube,centrifuged at 3000 r/min for 5 min,and serum was collected.Morning urine was collected using a 15 ml centrifuge tube.The contents of silicon in serum and urine of the subjects were determined by inductively coupled plasma mass spectrometry(ICP-MS),and the levels of TNF-α,TGF-β1and CC16 in blood were determined by enzyme linked immunosorbent assay(ELISA).Results 1 Compared with the control group,the contents of silicon element,TNF-α and TGF-β1 in serum and urine of silica dust exposure group and silicosis group were increased,and the content of silicon element in silica dust exposure group was the highest.2 CC16 content decreased in dust exposure group and dust exposure group,and CC16 level was the lowest in silicosis group.3 Urine silicon,blood silicon,TNF-α and TGF-β1 were risk factors for silicosis,and their OR values and 95%CI were 1.246(1.021-1.52),1.904(1.212-2.992),1.136(1.025-1.259)and 1.106(1.018-1.201),respectively.3 ROC curve analysis was used to test the differential ability of silicon in the diagnosis of silicosis.It was found that the sensitivity,specificity and area(AUC)of silicon level combined with other cytokines in vivo for silicosis was 98.6%,97.2%,and 0.974.4.Authenity and reliability analysis of silicon element and cytokine screening for silicosis showed that the sensitivity and specificity of silicon element combined with factors were the highest,and the values were both 1.000.The sensitivity and specificity of TNF-α were 0.923 and 0.886 respectively.The sensitivity and specificity of TGF-β1 were 0.923 and 0.614 respectively.5 Correlation analysis showed that urine silicon was significantly positively correlated with blood silicon,TNF-α and TGF-β1,and significantly negatively correlated with CC16.In addition,serum silicon was significantly positively correlated with TNF-α and TGF-β1,and negatively correlated with CC16.Conclusions Silicon element combined with related cytokines TNF-α,TGF-β1,CC16 can be used as an important reference for the diagnosis of silicosis,and has high diagnostic value.Figure 9;Table 15;Reference 147... |
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