儿童支原体大叶性肺炎肺泡灌洗液细胞因子与局部炎症的相关性  

Bronchoalveolar lavage fluid cytokine profile contributes to discriminating local inflammation in children with mycoplasma lobar pneumonia

作　　者：张阿敏 李国盛 李福海[1] ZHANG Amin;LI Guosheng;LI Fuhai(Department of Pediatrics,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China;Department of Hematology,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China)

机构地区：[1]山东大学齐鲁医院儿科,山东济南250012 [2]山东大学齐鲁医院血液科,山东济南250012

出　　处：《山东大学学报（医学版）》2022年第11期82-88,共7页Journal of Shandong University:Health Sciences

基　　金：山东省自然科学基金(ZR2020QH116)

摘　　要：目的 探讨儿童支原体大叶性肺炎肺泡灌洗液(BALF)中细胞因子与局部炎症的相关性。方法 选取2021年9月至12月在山东大学齐鲁医院儿科住院的大叶性肺炎患儿80例,按宏基因组二代测序(mNGS)结果分为2组:肺炎支原体(MP)组(n=51)、肺炎链球菌(SP)组(n=29)。MP组按发热时间分为2个亚组:发热≤7 d组(n=22)、发热>7 d组(n=29);按胸腔积液分为另外2个亚组:有胸腔积液组(n=18),无胸腔积液组(n=33)。比较各组BALF中细胞因子水平。结果 MP组BALF中IL-6/IL-10、IL-1β/IL-10水平高于SP组(P=0.027;P=0.015)、IL-17/IL-10水平低于SP组(P=0.045)。MP组中发热时间>7 d组BALF中IL-6/IL-10、IL-1β/IL-10、IL-17/IL-10、IL-12p70/IL-10、IL-4/IL-10水平高于发热时间≤7 d组(P=0.007;P=0.008;P=0.009;P=0.02;P=0.01)。MP组中有胸腔积液组BALF中IL-6/IL-10水平高于无胸腔积液组(P=0.005)。BALF中IL-6/IL-10、IL-1β/IL-10、IL-17/IL-10、IL-12p70/IL-10、IL-4/IL-10预测发热时间>7 d的曲线下面积(AUC)分别为0.721、0.719、0.716、0.691、0.712,IL-6/IL-10预测有胸腔积液的AUC为0.739。结论 MP大叶性肺炎BALF中IL-6、IL-1β、IL-17、IL-4水平与局部炎症反应相关,可作为评估患儿病情发展的重要指标。Objective To explore the relationship between cytokines in bronchoalveolar lavage fluid(BALF) with lobar pneumonia associated with mycoplasma pneumoniae(MP) in children. Methods A total of 80 children with MP lobar pneumonia treated during Sep. and Dec. 2021 were enrolled. The children were divided into two groups according to metagenome second generation sequencing(mNGS): MP group(n=51), and streptococcus pneumoniae(SP) group(n=29). According to fever duration, The MP group was subdivided into fever duration ≤7 d group(n=22) and >7 d group(n=29). According to pleural effusion, the MP group was subdivided into pleural effusion group(n=18) and non-pleural effusion group(n=33). Cytokines in BALF were compared. Results The levels of IL-6/IL-10 and IL-1β/IL-10 in the BALF of MP group were higher than those in the SP group(P=0.027, P=0.015), while the level of IL-17/IL-10 was lower in MP group than that in SP group(P=0.045). The levels of IL-6/IL-10, IL-1β/IL-10, IL-17/IL-10, IL-12 p70/IL-10, IL-4/IL-10 in fever during >7 days were higher than those in the fever duration ≤7 days(P=0.007, P=0.008, P=0.009, P=0.02, P=0.01). The level of IL-6/IL-10 in the pleural effusion group was significantly higher than that in the non-pleural effusion group(P=0.005). The area under the curve(AUC) of IL-6/IL-10, IL-1β/IL-10, IL-17/IL-10, IL-12 p70/IL-10, and IL-4/IL-10 in the fever duration >7 day were 0.721, 0.719, 0.716, 0.691 and 0.712, respectively. The AUC of IL-6/IL-10 in the pleural effusion group was 0.739. Conclusion The levels of IL-6, IL-1β, IL-17 and IL-4 in BALF of MP lobar pneumonia are associated with the local inflammatory response, which can be used as important indicators to evaluate disease progression in children.

关 键 词：大叶性肺炎 肺炎支原体 儿童 肺泡灌洗液 细胞因子 

分 类 号：R725.6[医药卫生—儿科]