甘肃某地日光温室作业者血清CC16与SP-D水平的研究
Levels of serum CC16 and SP-D among greenhouse workers from a village in Gansu Province
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摘要:
目的 了解日光温室作业者血清克拉氏细胞蛋白16(Clara cell 16，CC16)和表面活性蛋白-D(surfactant protein-D，SP-D)的分布特征及可能的影响因素。
方法 选择甘肃省某村782名日光温室作业者作为研究对象，采集其空腹静脉血，采用ELISA测定血清中CC16和SP-D质量浓度(下称浓度)。分析性别、年龄、体质指数(BMI)、从事日光温室种植时间、个人拥有日光温室数量、吸烟、饮酒、个人防护用品使用情况等因素对血清CC16、SP-D浓度及CC16/SP-D值的影响。
结果 日光温室作业者血清CC16浓度P5、P25、M、P75、P95分别为22.94、51.04、81.81、139.74、394.60 μg/L。不同年龄组间血清CC16浓度分布的差异具有统计学意义(P＜0.05)，且随年龄增大而降低(r=-0.145，P＜0.01)。多重线性回归结果显示，血清CC16浓度可能的影响因素为年龄(b'=0.183，P＜0.001)。血清SP-D浓度P5、P25、M、P75、P95分别为1.54、2.37、3.24、4.37、7.32 μg/L。不同年龄分组间血清SP-D浓度分布的差异具有统计学意义(P＜0.05)，年龄为46~60岁组血清SP-D水平最高；吸烟者浓度明显高于非吸烟者(P＜0.05)；个人拥有日光温室数量组间血清SP-D浓度分布的差异也具有统计学意义(P＜0.05)，拥有2个日光温室的作业人员血清SP-D水平最高。多重线性回归结果显示，血清SP-D浓度可能的影响因素为吸烟(b'=0.121，P=0.001)、从业时间(b'=0.087，P=0.015)、饮酒(b'=-0.081，P=0.026)。血清CC16/SP-D值的P5、P25、M、P75、P95分别为6.73、14.95、24.89、44.11、150.30。不同年龄组作业人员血清CC16/SP-D值分布的差异具有统计学意义(P＜0.05)，并随年龄增大而降低(r=-0.179，P＜0.01)。不同从业时间组间血清CC16/SP-D值分布的差异具有统计学意义(P＜0.05)，作业时间6~10年组人员最高；非吸烟者浓度明显高于吸烟者(P＜0.05)。多重线性回归结果显示，血清CC16/SP-D可能的影响因素为年龄(b'=-0.216，P＜0.001)和吸烟(b'=-0.076，P=0.031)。
结论 日光温室作业可能影响作业者血清CC16、SP-D和CC16/SP-D值水平，可能的影响因素为年龄、从业时间、吸烟及饮酒，提示血清CC16、SP-D和CC16/SP-D值可作为日光温室作业者呼吸系统健康损害的生物标志。
Abstract:Objective To describe the distribution and influencing factors of serum Clara cell 16 (CC16) and surfactant protein-D (SP-D) among greenhouse workers.
Methods A total of 782 greenhouse workers in a village of Gansu Province, China were enrolled to fill a questionnaire and their fasting venous blood samples were collected. ELISA was used to detect the concentrations of serum CC16 and SP-D. The effects of gender, age, body mass index (BMI), greenhouse working years, number of greenhouses owned, smoking, drinking, and individual protection equipment usage on serum CC16, SP-D, and CC16/SP-D were also analyzed.
Results The P5, P25, M, P75, and P95 levels of serum CC16 were 22.94, 51.04, 81.81, 139.74, and 394.60 μg/L, respectively. The levels of CC16 in subjects of different subgroups of age were significantly different (P < 0.05) and decreased with increasing age (r=-0.145, P < 0.01). Age was an influencing factor of serum CC16 level according to the result of multiple linear regression analysis (b'=-0.183, P < 0.001). The P5, P25, M, P75, and P95 levels of serum SP-D were 1.54, 2.37, 3.24, 4.37, and 7.32 μg/L, respectively. The levels of SP-D in subjects of different subgroups of age were significantly different (P < 0.05), and the level was highest in the 46-60 years old subgroup. The level of SP-D in current or former smokers was significantly higher than that in nonsmokers (P < 0.05). The levels of SP-D were also different among the subgroups with different numbers of greenhouses owned (P < 0.05), and the subgroup owing two greenhouses showed the highest level of SP-D. Smoking (b'=0.121, P=0.001), greenhouse working years (b'=0.087, P=0.015), and drinking (b'=-0.081, P=0.026) were influencing factors of serum SP-D level according to the results of multiple linear regression analysis. The P5, P25, M, P75, and P95 levels of serum CC16/SP-D were 6.73, 14.95, 24.89, 44.11, and 150.30, respectively. The CC16/SP-D in subjects of different subgroups of age were significantly different (P < 0.05) and decreased with increasing age (r=-0.179, P < 0.01). The ratios among subgroups of different greenhouse working years were statistically different (P < 0.05), and the 6-10 years subgroup showed the highest ratio. The ratio in non-smokers was significantly higher than that in current or former smokers (P < 0.05). Age (b'=-0.216, P < 0.001) and smoking (b'=-0.076, P=0.031) were influencing factors of CC16/SP-D ratio according to the results of multiple linear regression analysis.
Conclusion Greenhouse working might influence the levels of serum CC16 and SP-D and the ratio of CC16/SP-D in greenhouse workers. Possible influencing factors are age, greenhouse working years, smoking, and drinking. The findings indicate that serum CC16, SP-D, and CC16/SP-D may serve as biomarkers of respiratory injury in greenhouse workers.
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