儿童重型与轻型支原体肺炎免疫变化及临床意义  

Clinical significance of detecting immune function in children with slight or severe Mycoplasma pneumoniae pneumonia

作　　者：钱卫疆[1] 胡晓艳[1] 徐宋周[1] 翟岩[1] 周于新[1] 张双船[1] 

机构地区：[1]北京大学深圳医院儿科,广东深圳518036

出　　处：《中国现代医学杂志》2011年第23期2882-2885,共4页China Journal of Modern Medicine

基　　金：深圳市科技局一般项目(No:201002075)

摘　　要：目的检测儿童重型肺炎支原体肺炎(MPP)与轻型MPP的体液免疫及细胞免疫状况,为临床免疫治疗寻找依据。方法 157例MPP患儿按病情分为轻症组(132例)和重症组(25例),以同期儿科门诊体检的健康儿童25例为对照组,检测上述所有患儿急性期免疫指标。结果轻症组及重症组患儿IgG、IgM水平均高于对照组(均P<0.05),重症组患儿IgM较轻症组患儿水平高(P<0.05)。两组MPP患儿IgA与对照组比较,差异均无统计学意义(P<0.05);轻症及重症组患儿CD4+T细胞比例、CD4+/CD8+T细胞比值均低于对照组(均P<0.05),两组MPP患儿CD19+、CD8+T细胞比例均高于对照组,差异有统计学意义(P<0.05),且重症组CD19+T细胞比例高于轻症组,差异有统计学意义(P<0.05);重症组患儿CD3+、CD16+CD56+T细胞比例明显低于轻症组(均P<0.05)。结论 MPP感染患儿B淋巴细胞异常活化且T淋巴细胞和自然杀伤细胞(NK)免疫功能低下,重症组更明显。免疫制剂对MPP患儿临床治疗有效,对重症MPP疗效更明显。【Objective】 To detect the cellular and humoral immune in children with slight MPP or severe MPP to find the theoretical basis for its clinic immunotherapy.【Methods】 157 children with Mycoplasma pneumoniae pneumonia（MPP） enrolled were classified into two groups（132 cases in slight group and 25 cases in severe group） based on the severity of clinical prognostic.Fresh peripheral blood sample was treated from each case soon after it was diagnosed as MPP and was run through the flow cytometry（FCM）,the percentage of lymphocytes subsets were acquired using Simultest software simultaneously.Serum immunoglobulin IgG,IgM,IgA was measured,compared among the groups.In addition,25 healthy children were included as normal control group.【Results】 Both the slight MPP group and the severe MPP group show higher serum concentrations of IgG and IgM comparing with the controls.A significant difference for the serum concentrations of IgG and IgM was observed between each MPP group and the controls（P〈0.05）,and IgM is higher with the severe MPP group than that of the slight MPP group（P〈0.05）.IgA concentration between groups was not statistically significant（P〈0.05）.The content of CD4＋ and ratio of CD4＋ /CD8＋ was significantly lower than those of the controls,respectively the content of CD19＋ and CD8＋ with each MPP group was significantly higher than those of the controls（P〈0.05）.Comparison between the severe group and the slight group,CD19＋ content was significantly higher with the severe group than that of the slight group,respectively CD3＋,CD16＋ CD56＋ contents were significantly lower（P〈0.05） 【Conclusions】 MPP children＇s Blymphocytes were extremely activated and immunized function with both Tlymphocytes and natural killer cells（NK） were depressed.And it was more obvious for sever group.Immunized agents may play significant role in clinic treatment for MPP children,mostly for the severe MPP children.

关 键 词：肺炎支原体 肺炎 免疫 治疗 

分 类 号：R725.6[医药卫生—儿科]