肺炎支原体肺炎与肺表面活性物质相关蛋白A的相关性研究  

Relationship between surfactant protein-A and Mycoplasma pneumoniae pneumonia

作　　者：黄霞[1] 赵德育[1] 王全[1] 刘峰[1] 梁慧[1] Huang Xia Zhao Deyu Wang Quan Liu Feng Liang Hui(Department of Respiratory, Children＇s Hospital Affiliated to NJMU, Nanjing 210008, China)

机构地区：[1]南京医科大学附属儿童医院呼吸内科,江苏南京210008

出　　处：《南京医科大学学报（自然科学版）》2017年第6期719-722,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京市医学科技发展项目(201108012)

摘　　要：目的:探讨肺表面活性物质相关蛋白A(surfactant protein-A,SP-A)在肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)中的作用及临床意义。方法:收集2014年1月1日—2015年12月31日在南京医科大学附属儿童医院住院的肺炎患儿共51例:其中MPP患儿41例,分别为MPP组15例,MPP伴肺不张组26例,同时设立同期入院非支原体感染的普通肺炎10例为对照组,采用ELISA法检测各组患儿血清和肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中SP-A含量,逆转录聚合酶链反应方法(RT-PCR)检测血清SP-A m RNA相对表达情况。结果:(1)MPP组、MPP伴肺不张组血清、BALF中SP-A蛋白水平均低于对照组,差异均有统计学意义(P<0.05),但MPP组、MPP伴肺不张组之间差异无统计学意义(P>0.05)。(2)MPP组及MPP伴肺不张组血清SP-A含量及m RNA水平与BALF中SP-A蛋白含量均呈正相关(r=0.42,P=0.01;r=0.41,P=0.04)。(3)MPP伴肺不张组血清、BALF中SP-A含量及血清SP-A m RNA水平与肺复张时间无明显相关性(P值均>0.05)。结论:MPP患儿血清、BALF中SP-A蛋白含量明显下降,MPP中可能存在肺泡Ⅱ型细胞损伤,SP-A的替代治疗或促进SP-A生成的治疗对MPP的恢复将有一定意义。Objective： To investigate the role of surfactant protein A（SP-A） in children with Mycoplasma pneumoniae pneumonia（MPP）. Methods： A total of 51 inpatients diagnosed as pneumonia in Children’s Hospital Affiliated to NJMU were selected in the period from 2014-1-1 to 2015-12-30. Among the 51 patients, 41 were MPP patients, and divided into the MMP group（15 cases） and the MMP with atelectasis（MPPA） group（26 cases）; the 10 non-MP-induced pneumonia cases during the same period were selected as the control group. The protein levels of SP-A in serum and bronchoalveolar lavage fluid（BALF） were measured in each group by ELISA.The m RNA levels of SP-A in serum were tested with RT-PCR. Results：（1） The protein levels of SP-A（both the MMP and the MPPA group） were significantly decreased compared with the levels in the control group（P〈0.05）; However, there was no significance of protein level of SP-A between the MMP and the MMPA group（P〉0.05）.（2） The protein and m RNA levels of SP-A in serum were positive relatively with those in BALF（r=0.42, P=0.01;r=0.41, P=0.04）.（3） The protein and m RNA levels of SP-A showed no correlation with the time of pulmonary re-expansion both in the MMP and the MMPA groups（both P〉0.05）. Conclusion： Patients with MPP have decreased SP-A levels in serum and BALF. SP-A cevels reflect alveolar type Ⅱ epithelial cell injury potentially, and thus surfactant replacement or increasing SP-A generation might be efficacious for the treatment of MPP.

关 键 词：肺表面活性物质 肺炎支原体 肺不张 儿童 

分 类 号：R725.6[医药卫生—儿科]