重症肺炎患儿血清免疫球蛋白检测的临床意义  

The Clinical Significance of Serum Immunoglobulin Level in Children with Severe Pneumonia

作　　者：田婷[1,2] 尹文艳[1] 杨勤[3] 

机构地区：[1]贵阳市妇幼保健院呼吸科,贵州贵阳550003 [2]贵州医科大学 [3]贵州医科大学病理生理教研室,贵州贵阳550004

出　　处：《贵阳医学院学报》2015年第11期1226-1228,1232,共4页Journal of Guiyang Medical College

摘　　要：目的:了解重症肺炎患儿免疫球蛋白(Ig)A、Ig G及Ig M变化与其临床特征的关系。方法:住院治疗的重症肺炎患儿100例为观察组,健康体检的正常健康儿童30例为对照组,采用免疫比浊发测定观察组入院时和对照组体检当日清晨血清Ig A、Ig G及Ig M水平,记录Ig A、Ig G及Ig M降低在重症肺炎患儿的构成类型,分析不同Ig降低类型与重症肺炎患儿体温控制时间、肺部啰音吸收时间及临床治愈时间的关系。结果:观察组患儿血清Ig A、Ig G水平较对照组儿童低(P<0.05);重症肺炎患儿血清Ig降低以Ig A+Ig G二联为主,其次为Ig A降低和Ig A+Ig G+Ig M三联降低,单一Ig G降低及Ig A+Ig M二联降低少见,单一Ig M降低及Ig G+Ig M二联降低未见;Ig A+Ig G+Ig M三联降低型的重症肺炎患儿体温控制时间较Ig A+Ig G二联降低及单一Ig A降低患儿长;Ig A+Ig G+Ig M三联和Ig A+Ig G二联降低型患儿的肺部啰音吸收时间及住院时间较单一Ig A降低的患儿延长(P<0.05)。结论:重症肺炎患儿存在Ig降低,当存在两种或以上Ig降低时,临床上治疗难度较大。Objective： To investigate the relationship between the change of serum immunoglobulin（ IgA,IgG,IgM） in children with severe pneumonia and their clinical features. Methods： Selecting100 hospitalized children with severe pneumonia as observation group and 30 healthy children as control group. Immunoturbidimetry was used to measure the value of IgA,IgG and IgM of both groups,and recording the constituent type of the decrease of IgA,IgG and IgM. Then,comparing temperature change,pulmonary rale absorption time and clinical cure time of patients in different Igdecrease type.Results： Serum IgA and IgG levels in observation group were significantly lower than those of control group,the difference was statistically significant（ P〈0. 05）. Further analysis showed that most of the children with severe pneumonia had IgA ＋ IgG reduction simultaneously,followed by IgA reduction and then IgA ＋ IgG ＋ IgM simultaneous reduction; IgG reduction only and IgA ＋ IgM simultaneous reduction were scarce. Moreover,IgM reduction only and IgG ＋ IgM simultaneous reduction were not found in this study. Concerning temperature control,children with IgA ＋ IgG ＋ IgM simultaneous reduction needed longer time than the IgA reduction group and IgA ＋ IgG reduction group,while there is no significant difference in temperature control between children with IgA ＋ IgG simultaneous reduction and children with IgA reduction only. Concerning pulmonary rale absorption time and cure time,children with IgA reduction only were obviously shorter than the IgA ＋ IgG reduction group and IgA ＋ IgG ＋ IgM reduction group,the difference was statistically significant（ P〈0. 05）. Conclusion： If children havetwo or more immunoglobulins decreased,the clinical treatment will be harder and recovery will be slower.

关 键 词：儿童 重症肺炎 免疫球蛋白 免疫球蛋白A 免疫球蛋白G 免疫球蛋白M 

分 类 号：R363[医药卫生—病理学]