肺炎支原体感染与全身型幼年特发性关节炎患儿预后的关系  

Relationship between Mycoplasma Pneumoniae Infection and Prognosis of Systemic Onset Juvenile Idiopathic Arthritis in Children

作　　者：张文明[1] 蔡宇波[1] 曹兰芳[1] 李亚琴[1] 毛海英[1] 

机构地区：[1]上海交通大学医学院附属仁济医院儿科,上海200001

出　　处：《实用儿科临床杂志》2010年第22期1726-1727,1747,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨肺炎支原体(MP)感染与全身型幼年特发性关节炎(SoJIA)预后的关系。方法收集2004-2009年在本院住院或门诊就诊SoJIA患儿49例。采用日本富士瑞必欧株式会社提供的赛乐迪亚麦可ⅡMP抗体诊断试剂盒,以被动凝集法检测其MP-IgM抗体。操作过程严格按试剂盒说明书进行,血清稀释度≥1:160或在2周内检测2次下降或增高4倍为阳性,并根据结果将患儿分为MP-IgM阳性组和MP-IgM阴性组。根据患儿随访24个月期间的病情、病程,将患儿分为单相病程组(13例)和非单相病程组(36例)(包括多相病程和持续相病程),同时记录患儿初诊时和24个月随访时实验室指标和疾病相关的系统症状,并进行整理和分析。结果 SoJIA患儿中,MP-IgM阳性组和MP-IgM阴性组之间患儿初诊时ESR、CRP、PLT、铁蛋白及疾病相关系统症状评分的差异均无统计学意义;但SoJIA患儿病程中MP-IgM阳性组铁蛋白和全身系统症状评分在24个月随访时明显高于MP-IgM阴性组(Pa<0.05)。单相病程组患儿MP-IgM阳性率为38.5%,非单相病程组患儿MP-IgM阳性率为80.6%,二组比较差异有统计学意义(2χ=7.967,P=0.005)。结论 MP感染可能影响SoJIA的预后。Objective To explore the relationship between the mycoplasma pneumoniae（MP） infection and the prognosis of systemic onset juvenile idiopathic arthritis（SoJIA）.Methods Forty-nine SoJIA patients were collected in Renji Hospital from2004 to 2009 as researching cases.MP antibody of serum（MP-IgM） was tested by Serodia-MycoⅡ which was manufactured by using artificial gelatin particles sensitized with cell-membrane components of MP（Mac strain）,and titres≥1：160 or advanced/decreased four-fold within 2 weeks were recognized as positive.According to the results of the test,patients were divided into 2 groups：MP-Ig Mpositive group and MP-IgMnegative group.SoJI Apatients also were divided into 2 groups depending on their course of disease when the follow-up period reached 24 months：monophasic group and non-monophasic（polycyclic and persistent） group.The C reactive protein（CRP）,ferritin and systemic feature score of SoJIApatients were recorded.The systemic features were assessed interms of fever,rash,lymphadenopathy in cervical,axillary,and inguinal regions,hepatomegaly,splenomegaly,and serositis.Results Of all the indexs atinitial treatment,there was no obvious difference between MP-IgMpositive group and MP-IgMnegative group,but there was significant difference in 24 months of iron protein and system score（Pa0.05）;and the incidence of MP infection（38.5%） was higher in patients with non-monophasic SoJIA（80.6%）（χ2=7.967,P=0.005）.Conclusion Infection may influnence and change the disease course of SoJIA.

关 键 词：肺炎支原体 全身型幼年特发性关节炎 预后 

分 类 号：R725.6[医药卫生—儿科]