Wen K, Ding C G, Chen G, Ma G X, Wang H Q
National Institute of Occupational Health and Poison Control, Chinese Center of Disease Control and Prevention, Beijing 100050, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2017 Nov 20;35(11):832-836. doi: 10.3760/cma.j.issn.1001-9391.2017.11.007.
To detect of the components and concentration of the metals and metalloids in the lavage fluid of whole-lung lavage (WLL) of the cases of pneumoconiosis, and analyze the characteristics, and explore the method to sample and process the samples of bronchoalveolar lavage fluid (BAL) . The samples of urine and serum of three cases of pneumoconiosis were collected before WLL, and the samples of BAL were collected during the WLL from the left and right lungs according to the sequence of four pressured gas flow and five negative pressure drainage. Each of 10ml original samples of WLL was collected firstly, and the left was centrifuged to acquire all the sediment samples and each of 10 ml samples from the centrifuge clear liquids, The components and concentration of the metals and metalloids in the samples were measured by Inductively Coupled Plasma mass spectrometer (ICP-MS) . The average volume of BAL from unilat-eral lung for 3 patients was 10 758.3±1518 ml, and the average recovery rate was 89.7%. The average dry weight of sediment samples of BAL of three cases of pneumoconiosis was 0.292 gram with the right lung sam-ples slightly higher than the left lung samples. The detectable elements from the samples included Barium (Ba) , Strontium (Sr) , Calcium (Ca) , Magnesium (Mg) , Manganum (Mn) , Ferrum (Fe) , Cuprum (Cu) , Zinc (Zn) , Kalium (K) , Natrium (Na) , Selenium (Se) , Silicon (Si) and Uranium (U) . Each of concentration dis-tributions of these elements were not normal. Except for Cuprum, Selenium and Uranium, the concentrations of the other ten elements in the supernatant samples, mixture samples and sediments samples were statistical-ly different with the nonparametric test of Kruskal-Wallis. The concentrations of Natrium, Kalium and Barium in supernatant samples were higher, while the others in precipitation samples were higher. The concentration of elements in the sample from the right lung was slightly higher than that from the left lung, but there was no statistically significant difference (>0.05) . There were statistical difference in term of element concentration of precipitates samples before and after pressured gas flow (<0.05) . The concentration of K、Ca、Mg、Si and Se in se-rum, urine, supernatant and sediment samples had a good correlation. The correlation coefficient of Silicon between serum and precipitation was 0.676 and that between urine and precipitation was 0.524. The concentra-tions of the metals and metalloid in sediment samples were more stable than that of supernatant and mixture samples. The sampling of one-side lung lavage fluid was representative in the detection of metals and metalloid in the BAL. It was the best time for sampling sediment from the BAL after the first pressured gas flow among the WLL.
检测尘肺病患者全肺灌洗（WLL）灌洗液中金属和类金属的成分及浓度，分析其特点，并探索支气管肺泡灌洗液（BAL）样本的采集及处理方法。采集3例尘肺病患者WLL术前的尿液和血清样本，在WLL术中按照4次正压通气和5次负压引流的顺序从左右肺采集BAL样本。首先各采集10ml WLL原液样本，剩余样本离心获取所有沉淀样本及10ml离心后的上清液样本，采用电感耦合等离子体质谱仪（ICP-MS）测定样本中金属和类金属的成分及浓度。3例患者单侧肺BAL平均灌洗量为10758.3±1518ml，平均回收率为89.7%。3例尘肺病患者BAL沉淀样本平均干重为0.292g，右肺样本略高于左肺样本。样本中可检测出的元素包括钡（Ba）、锶（Sr）、钙（Ca）、镁（Mg）、锰（Mn）、铁（Fe）、铜（Cu）、锌（Zn）、钾（K）、钠（Na）、硒（Se）、硅（Si）和铀（U）。这些元素的浓度分布均不正常。除铜、硒和铀外，其他10种元素在上清液样本、混合样本和沉淀样本中的浓度经Kruskal-Wallis非参数检验有统计学差异。上清液样本中钠、钾和钡的浓度较高，而沉淀样本中其他元素的浓度较高。右肺样本中元素浓度略高于左肺样本，但无统计学差异（>0.05）。正压通气前后沉淀样本的元素浓度有统计学差异（<0.05）。血清、尿液上、清液和沉淀样本中钾、钙、镁、硅和硒的浓度具有良好的相关性。血清与沉淀中硅的相关系数为0.676，尿液与沉淀中硅的相关系数为0.524。沉淀样本中金属和类金属的浓度比上清液和混合样本更稳定。单侧肺灌洗液采样在检测BAL中金属和类金属方面具有代表性。在WLL中首次正压通气后采集BAL沉淀样本是最佳采样时间。
