肺炎支原体肺炎初诊患儿免疫状态分析  

Analysis of Immune Status in Children with First Visiting Mycoplasma Pneumoniae Pneumonia

作　　者：张晓峰 崔玉宝 何勇 韩菲菲 ZHANG Xiaofeng;CUI Yubao;HE Yong;HAN Feifei(Department of Medical Laboratory,Wuxi People′s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Pediatric Respiratory,Wuxi People′s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院医学检验科,江苏无锡214023 [2]南京医科大学附属无锡人民医院儿童呼吸科,江苏无锡214023

出　　处：《医学综述》2019年第23期4757-4761,共5页Medical Recapitulate

基　　金：江苏省重点研发计划(BE2018627);无锡市卫生计生科研重大项目(Z201701)

摘　　要：目的探讨初诊肺炎支原体肺炎(MPP)患儿机体免疫功能指标的改变及临床意义。方法收集2018年6月至2019年3月在南京医科大学附属无锡人民医院儿童住院部初诊172例MPP患儿作为研究对象,其中轻症105例,重症67例;同期选取性别、年龄相匹配的63名健康体检者作为对照组。流式细胞术检测各组外周全血T淋巴细胞亚群分子指标CD3^+、CD4^+、CD8^+、CD4^+/CD8^+,并采用免疫比浊法测定各组血清免疫球蛋白IgG、IgM、IgA的水平。结果轻症和重症MPP组CD3^+、CD4^+、CD4^+/CD8^+水平低于对照组,且重症MPP组CD3^+、CD4^+、CD4^+/CD8^+水平低于轻症组[(43.1±16.7)%比(55.3±18.8)%、(16.1±6.8)%比(24.3±8.1)%、0.64±0.28比0.97±0.29](P<0.05),各组CD8+比较差异无统计学意义(P>0.05)。轻症和重症MPP组血清IgG、IgM、IgA水平均较对照组明显升高(P<0.05)。结论未接受药物治疗的初诊重症MPP患儿T淋巴细胞亚群CD3^+、CD4^+、CD4^+/CD8^+水平较健康对照和轻症患儿明显降低,Ig水平升高。初诊MPP患儿的免疫状态检测可为临床诊疗提供参考依据。Objective To explore the changes of immune function and clinical significance in children with newly diagnosed mycoplasma pneumoniae pneumonia(MPP).Methods From June 2018 to March 2019,172 children with MPP who were initially diagnosed in the children′s inpatient department of Wuxi People′s Hospital Affiliated to Nanjing Medical University were selected as the observation group,including 105 patients with mild MPP and 67 patients with severe MPP;63 healthy people matched in age and gender were selected as the control group.Flow cytometry was used to detect CD3^+,CD4^+,CD8^+,CD4^+/CD8^+,and immunoturbidimetry was used to detect the levels of IgG,IgM and IgA in the serum of each group.The clinical application value of immune indexes in light and severe MPP was analyzed.Results The levels of CD3^+,CD4^+,CD4^+/CD8^+ in the mild and severe MPP groups were significantly lower than those in the control group,and the levels of CD3^+,CD4^+,CD4^+/CD8^+ in the severe MPP group were lower than those in the mild MPP group[(43.1±16.7)% vs(55.3±18.8)%,(16.1±6.8)% vs(24.3±8.1)%,0.64±0.28 vs 0.97±0.29](P<0.05),and there was no significant change in CD8^+ in each group(P>0.05).The levels of IgG,IgM and IgA in the mild and severe MPP group were significantly higher than those in the control group(P<0.05).Conclusion the levels of CD3^+,CD4^+,CD4^+/CD8^+ in T-lymphocyte subsets of children with MPP were significantly lower than those of healthy controls and children with mild MPP.The detection of the immune status of the newly diagnosed MPP children can provide reference for clinical diagnosis and treatment.

关 键 词：肺炎支原体肺炎 初诊 细胞免疫 体液免疫 

分 类 号：R563.1[医药卫生—呼吸系统]