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[血清Ⅲ型前胶原肽在矽肺和博来霉素毒性所致肺纤维化诊断中的应用]

[Serum type III procollagen peptide in diagnosis of lung fibrosis due to silicosis and bleomycin toxicity].

作者信息

Okuno F, Maruyama K, Okazaki I, Arai M, Suzuki H

出版信息

J UOEH. 1986 Mar 20;8 Suppl:355-61.

PMID:2425407
Abstract

Early diagnosis of lung fibrosis has been hampered by the lack of a simple, convenient and specific test. Measurement of serum type III procollagen peptide (Pro (III)-N-P) by the method originally developed by Rohde et al. has been shown to be useful for the evaluation of hepatic fibrosis. The present study, therefore, was carried out to investigate the usefulness of the measurement of Pro (III)-N-P in 24 patients with lung fibrosis due to silicosis, and in 7 patients with malignant lymphoma treated with bleomycin, antitumor antibiotic which has the adverse effect of producing fibrosis in the lung. The normal value of the peptide in adults was 8.60 +/- 2.35 ng/ml (mean +/- SD; n = 68) and the normal upper level was set at 13.4 ng/ml (mean +/- 2SD). Patients with silicosis had significantly but not extremely high levels of the peptide and 25% of the patients showed abnormally high values. The level of Pro (III)-N-P was associated with neither physical findings, chest X-p findings nor pulmonary function test results. Three of 7 patients showed increased levels during treatment with bleomycin. In one case, a total dose of 120 mg of bleomycin for over a period of 14 months markedly increased the level of the peptide. These observations suggest that the determination of Pro (III)-N-P may be useful for the detection of lung fibrosis.

摘要

由于缺乏一种简单、便捷且特异的检测方法,肺纤维化的早期诊断一直受到阻碍。采用罗德等人最初研发的方法测定血清III型前胶原肽(Pro(III)-N-P),已被证明对评估肝纤维化有用。因此,本研究旨在探讨测定Pro(III)-N-P在24例矽肺所致肺纤维化患者以及7例接受博来霉素治疗的恶性淋巴瘤患者中的应用价值,博来霉素是一种具有导致肺部纤维化副作用的抗肿瘤抗生素。该肽在成年人中的正常值为8.60±2.35 ng/ml(均值±标准差;n = 68),正常上限设定为13.4 ng/ml(均值±2标准差)。矽肺患者的该肽水平显著升高,但并非极高,25%的患者呈现异常高值。Pro(III)-N-P水平与体格检查结果、胸部X线检查结果以及肺功能测试结果均无关联。7例患者中有3例在博来霉素治疗期间水平升高。在1例患者中,14个月内累计使用120 mg博来霉素显著提高了该肽的水平。这些观察结果表明,测定Pro(III)-N-P可能对检测肺纤维化有用。

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