肺炎支原体感染儿童免疫功能、C-反应蛋白及D-二聚体的变化及临床意义  

Changes and clinic significance of immune function, C-reactive protein and D-Dimer in children with mycoplasma pneumoniae infection

作　　者：毛艳 柴建农 王海红 Mao Yah, Chai Jiannong , Wang Haihong(Deparment of Pediatrics, Changshu Hospital Affiliated to Suzhou University, the First People＇ s Hospital of Changshu, Changshu 215500, Chin)

机构地区：[1]苏州大学附属常熟医院常熟市第一人民医院儿科,江苏常熟215500

出　　处：《中国实用医刊》2018年第4期32-35,共4页Chinese Journal of Practical Medicine

摘　　要：目的检测肺炎支原体感染患儿T淋巴细胞亚群、C-反应蛋白（CRP）、D-二聚体水平，探讨其变化及临床意义。方法采用病例对照研究方法，选取53例肺炎支原体感染患儿作为实验组，其中肺炎支原体抗体（MP-IgM）滴度〉5 Au/ml≤15 Au/ml为低滴度组，共28例；MP-IgM滴度为〉15 Au/ml为高滴度组，共25例；另外选取30例健康体检儿童作为对照组。分别测定T淋巴细胞亚群、CRP、D-二聚体等水平。结果①实验两组CD4＋、CD4＋/CD8＋比值较对照组明显下降，差异有统计学意义（P〈0.05）；高滴度组CD4＋、CD4＋/CD8＋比值均低于低滴度组，差异有统计学意义（P〈0.05）；实验两组CD8＋细胞较对照组升高，差异有统计学意义（P〈0.05），高滴度组CD8＋高于低滴度组，差异有统计学意义（P〈0.05）。②实验两组CRP检测结果均比对照组升高，差异均有统计学意义（P〈0.05），高滴度组CRP值高于低滴度组，但差异未见统计学意义（P〉0.05）；③实验两组D-二聚体水平均高于对照组，差异有统计学意义（P〈0.05），高滴度组D-二聚体高于低滴度组，且差异有统计学意义（P〈0.05）。结论细胞免疫功能紊乱在肺炎支原体感染患儿发病机制中起着重要作用，感染越重，细胞免疫功能紊乱越明显。CRP动态监测有助于判断疾病的轻重程度，D-二聚体的测定有利于早期发现高凝状态，对疾病的评估及治疗有临床指导意义。ObjectiveTo investigate the changes and clinical significance of T-lymphocyte subsets, C-reactive protein and D-Dimer levels in children with mycoplasma pneumoniae infection.MethodsA case control study was carried out for 53 children with mycoplasma pneumoniae infection. The 53 patients were divided into two groups according to the MP-IgM plasma titers, namely low-titer group with MP-IgM〉5 Au/ml≤15 Au/ml （n=28）and high-titer group with MP-IgM〉15 Au/ml （n=25）. The subjects of control group（n=30）were recruited from healthy children as they took routine physical examination during the same period. The levels of T-lymphocyte subsets, C-reactive protein and D-Dimer were detected.Results①The levels of CD4＋ , CD4＋ /CD8＋ in the low-titer group and high-titer group were significantly lower than those in the control group（P〈0.05）. The levels of CD4＋ , CD4＋ /CD8＋ in the high-titer group were significantly lower than those in low-titer group（P〈0.05）. The levels of CD8＋ in the low-titer group and high-titer group were significantly higher than those in the control group （P〈0.05）. The levels of CD8＋ T in the high-titer group were significantly higher than those in low-titer group （P〈0.05）. ②The levels of C-reactive protein in the low-titer group and high-titer group were significantly higher than those in the control group（P〈0.05）. But the levels of C-reactive protein in the high-titer group were not significantly different from those in the low-titer group（P〉0.05）. ③The levels of D-Dimer in the low-titer group and high-titer group were significantly higher than those in the control group（P〈0.05）. The levels of D-Dimer in the high-titer group were significantly higher than those in low-titer group （P〈0.05）.ConclusionsCellular immunedysfunction plays an important role in the pathogenesis of children with mycoplasma pneumoniae infection. Dynamic monitoring of C-reactive protein is helpful to judge the severity of the disease. Determination of

关 键 词：肺炎支原体 细胞免疫功能紊乱 C反应蛋白 D-二聚体 

分 类 号：R725.6[医药卫生—儿科]