Karataş Mevlüt, Gündüzöz Meşide, Öziş Türkan Nadir, Özakıncı Osman Gökhan, Ergün Dilek
Department of Chest Diseases, Occupational and Environmental Diseases Hospital, Ankara, Turkey.
Department of Family Medicine, Occupational and Environmental Diseases Hospital, Ankara, Turkey.
Clin Respir J. 2019 Mar;13(3):159-165. doi: 10.1111/crj.12997. Epub 2019 Feb 3.
Occupational exposure to crystalline silica over time may result in silicosis: a fatal, irreversible occupational disease leading to lung function impairment. A complex inflammatory process, excessive accumulation of mesenchymal cells and collagen production are the primary mechanisms underlying silicosis. Neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) have emerged as representative indices of systemic inflammation.
The purpose of the present study was to investigate the relationship between NLR, PLR and silicosis.
We retrospectively analysed the demographic and laboratory data of ceramic workers who were referred to our Hospital between 2010 and 2018. Five hundred and seventy-three patients with silicosis and 222 ceramic workers without silicosis (controls) were included in the study.
The radiographic ILO classification of silicosis patients was as follows: category 1 (71.5%), category 2 (19.2%), category 3 (7.5%). NLR and PLR in categories 2 and 3 were significantly higher when compared with the control group (P < .005). FEV , FEV %, FVC, FVC % and PEF were significantly lower in all silicosis patients and also in patients with subcategories (all P < .005). NLR showed a poor positive correlation with CRP (r = 0.095, P < .05) and ESR (r = 0.207, P = .000) while PLR only with ESR (r = 0.317, P = .000) in patients with silicosis. NLR and PLR showed negative correlations with FEV , FVC and PEF (all P < .005).
We conclude that NLR and PLR have significant but poor correlations with pulmonary functions and severity of silicosis, especially in late radiographic profusion categories.
长期职业性接触结晶硅石可能导致矽肺病，这是一种致命的、不可逆转的职业病，会导致肺功能受损。复杂的炎症过程、间充质细胞过度积聚和胶原蛋白生成是矽肺病的主要发病机制。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）已成为全身炎症的代表性指标。
本研究旨在探讨NLR、PLR与矽肺病之间的关系。
我们回顾性分析了2010年至2018年间转诊至我院的陶瓷工人的人口统计学和实验室数据。本研究纳入了573例矽肺病患者和222例无矽肺病的陶瓷工人（对照组）。
矽肺病患者的国际劳工组织（ILO）影像学分类如下：1类（71.5%），2类（19.2%），3类（7.5%）。2类和3类患者的NLR和PLR显著高于对照组（P < 0.005）。所有矽肺病患者及其亚组患者的第1秒用力呼气容积（FEV₁）、第1秒用力呼气容积占预计值百分比（FEV₁%）、用力肺活量（FVC）、用力肺活量占预计值百分比（FVC%）和呼气峰值流速（PEF）均显著降低（所有P < 0.005）。在矽肺病患者中，NLR与C反应蛋白（CRP）呈弱正相关（r = 0.095，P < 0.05），与红细胞沉降率（ESR）呈正相关（r = 0.207，P = 0.000），而PLR仅与ESR呈正相关（r = 0.317，P = 0.000）。NLR和PLR与FEV₁、FVC和PEF呈负相关（所有P < 0.005）。
我们得出结论，NLR和PLR与矽肺病的肺功能及严重程度存在显著但较弱的相关性，尤其是在影像学晚期大量类别中。
