Altin Remzi, Armutcu Ferah, Kart Levent, Gurel Ahmet, Savranlar Ahmet, Ozdemir Hüiseyin
Zonguldak Karaelmas University School of Medicine, Department of Pulmonology, Turkey.
Int J Hyg Environ Health. 2004 Oct;207(5):455-62. doi: 10.1078/1438-4639-00316.
In miners exposed to coal dusts, coal worker's pneumoconiosis (CWP) can occur. The purpose of the present study is to better understand the relations between coal dust exposure and activities of blood plasma antioxidant enzymes, namely, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and lipid peroxidation end product malondialdehyde (MDA) concentration in coal workers with early and low grade simple CWP diagnosed by high resolution computed tomography (HRCT). Forty-three coal workers who had profusions of 0/1-2/2 according to ILO 1980 chest X-ray (CXR) classification, 43 coal workers without CWP (control group 1) and 44 healthy subjects (control group 2) who were randomly selected from the population register or recruited from the hospital staff were enrolled. Coal workers were reevaluated by HRCT (Hosoda-Shida classification) due to its higher sensitivity than standard CXR. Then, blood plasma SOD and GSH-Px activities and MDA plasma levels were measured. CWP was found positive in 46 of 89 coal workers by HRCT evaluation. Profusion 0 (P0, CWP not present), profusion 1 (P1, early CWP) and profusion 2 (P2, low grade CWP) were found in 43, 23 and 19 of patients found to have CWP by HRCT, respectively. We had no worker with profusion 3 (P3). Complicated CWP was shown in four of 46 patients and thesecases were excluded as the study was restricted to early and low-grade pneumoconiosis. In respect to the plasma levels of MDA and plasma activities of SOD and GSH-Px, statistically significant differences were found between CWP cases and control groups (p < 0.01, p < 0.01, p < 0.001 respectively). Statistical differences were also obtained for the plasma activities of SOD and GSH-Px and levels of MDA in relation to HRCT profusions (p < 0.05). In conclusion, these findings suggest an oxidative stress due to increased free radicals and reactive oxygen metabolite production in early stages and low grades of simple CWP diagnosed by HRCT.
在接触煤尘的矿工中，可能会发生煤工尘肺（CWP）。本研究的目的是更好地了解煤尘暴露与血浆抗氧化酶（即超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-Px））的活性以及通过高分辨率计算机断层扫描（HRCT）诊断为早期和低级别单纯性CWP的煤工中脂质过氧化终产物丙二醛（MDA）浓度之间的关系。根据国际劳工组织1980年胸部X线（CXR）分类，选取了43名肺野分布为0/1-2/2的煤工、43名无CWP的煤工（对照组1）以及44名从人口登记册中随机选取或从医院工作人员中招募的健康受试者（对照组2）。由于HRCT比标准CXR具有更高的敏感性，因此对煤工进行了HRCT复查（细田-志田分类）。然后，测量血浆SOD和GSH-Px活性以及血浆MDA水平。通过HRCT评估，89名煤工中有46名被发现患有CWP。在通过HRCT发现患有CWP的患者中，分别有43例、23例和19例肺野分布为0（P0，无CWP）、1（P1，早期CWP）和2（P2，低级别CWP）。我们没有肺野分布为3（P3）的工人。46例患者中有4例显示为复杂性CWP，由于本研究仅限于早期和低级别尘肺，因此这些病例被排除。关于血浆MDA水平以及SOD和GSH-Px的血浆活性，在CWP病例与对照组之间发现了统计学上的显著差异（分别为p<0.01、p<0.01、p<0.001）。还获得了与HRCT肺野分布相关的SOD和GSH-Px血浆活性以及MDA水平的统计学差异（p<0.05）。总之，这些发现表明，在通过HRCT诊断的早期和低级别单纯性CWP中，由于自由基和活性氧代谢产物产生增加，存在氧化应激。
