系统性炎症反应指数与接尘工人肺功能损害的相关性研究

Study on correlation between systemic inflammatory response index and lung function impairment in dust-exposed workers

关键词: 粉尘暴露  全身炎症指标  血常规  职业健康监护

Keywords: dust exposure  systemic inflammatory markers  blood routine test  occupational health surveillance

摘 要: 目的 探讨全身炎症指标与接尘工人粉尘暴露程度及肺功能受损情况之间的相关性,筛选用于提示粉尘接触工人疾病状态的最佳全身炎症指标, 强化尘肺病二级预防。方法 采用横断面调查方法, 纳入 222 名研究对象, 其中粉尘接触组 163 人、非粉尘接触组 59 人;收集其人口学特征、粉尘暴露情况、血常规指标、全身炎症指标及肺功能参数等信息,通过相关性分析、线性回归分析等方法,评估粉尘暴露情况、肺功能参数与全身炎症指标之间的相关性。结果 粉尘接触组中性粒细胞-淋巴细胞比率(neutrophil-to-lymphocyte ratio, NLR)、系统性免疫-炎症指数(systemic immune inflammation index, SII)、系统性炎症反应指数(systemic inflammation response index, SIRI) 和系统性炎症综合指数(aggregate index of systemic inflammation, AISI)水平显著高于非粉尘接触组[NLR: (2.12±0.99) vs.(1.68±0.59), P=0.00;SII:(499.96±297.31) vs.(413.24±162.50), P=0.01; SIRI:(0.90±0.66) vs. (0.62±0.30),P=0.00; AISI:(215.61±187.13)vs. (154.05±82.31), P=0.00],而淋巴细胞-单核细胞比率(lymphocyte-to-monocyte ratio, LMR)水平降低[(5.55±1.67)vs. (6.14±1.57), P=0.02]。 在控制潜在混杂因素后,接尘工龄与 NLR(r=0.171, P=0.011) 和SIRI(r=0.128, P=0.059)呈正相关, 接尘工龄每增加 1 年, NLR 和 SIRI 的水平分别增加约 0.022 和 0.010 单位; SIRI、AISI 与 FEV1.0%则显示出负相关性(SIRI: r=-0.213, P=0.007; AISI: r=-0.200, P=0.011), SIRI、AISI 与 FVC%亦呈负相关(SIRI: r=-0.231, P=0.003; AISI:r=-0.208, P=0.009),LMR 与 FVC%、PEF%之间仅观察到边缘显著的低相关性(r=0.136、-0.138, P<0.1)。结论 SIRI 与接尘时间及肺功能受损均具有较好的相关性,有助于在职业健康监护中筛选出高危接尘人员,为粉尘暴露工人的职业健康监护提供了新的手段。

Abstract: Objective To explore the correlation between systemic inflammatory indicators and the degree of dust exposure and lung function impairment in dust-exposed workers, to screen the optimal systemic inflammatory markers for indicating the disease status of dust-exposed workers, thereby strengthening the secondary prevention of pneumoconiosis. Methods Using a crosssectional study method, 222 subjects, including 163 dust-exposed workers and 59 non-dust-exposed workers were included, collect the data including their demographic characteristics, dust exposure conditions, blood routine indicators, systemic inflammatory indicators (NLR, LMR, PLR, SII, SIRI, and AISI), and lung function parameters, then, evaluate the relationship among dust exposure conditions, lung function parameters, and systemic inflammatory indicators through correlation analysis, linear regression analysis, and other methods. Results The results showed that levels of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI) and aggregate index of systemic inflammation (AISI) in dust-exposed group were significantly higher than those of non-dust-exposed group [NLR:(2.12±0.99)vs. (1.68±0.59), P=0.00; SII: (499.96±297.31)vs. (413.24±162.50), P=0.01; SIRI: (0.90±0.66) vs.(0.62±0.30), P=0.00; AISI: (215.61±187.13) vs. (154.05±82.31), P=0.00], while the lymphocyte-to-monocyte ratio (LMR)level was decreased [(5.55±1.67)vs. (6.14±1.57), P=0.02]. After controlling for potential confounding factors, the dust exposure duration was positively correlated with NLR (r=0.171, P=0.011) and SIRI (r=0.128, P=0.059), and for each additional year of exposure, the levels of NLR and SIRI increased by approximately 0.022 and 0.010 units, respectively; SIRI and AISI were negatively correlated with FEV1.0% (SIRI:r=-0.213, P=0.007; AISI: r=-0.200, P=0.011); SIRI, AISI and FVC% also showed a negative correlation (SIRI:r=-0.231, P=0.003; AISI:r=-0.208, P=0.009), only marginal significant low correlations were observed between LMR and FVC% as well as PEF% (r=0.136 and -0.138, respectively, P<0.1). Conclusion The results suggested that SIRI had a good correlation with dust exposure length and lung function impairment, which was helpful for screening high risk dust-exposed personnel in occupational health surveillance, thereby providing a new means for occupational health surveillance of dust-exposed workers.