支原体肺炎患儿肺泡灌洗液MP-DNA载量、免疫炎性指标与治疗效果的关系研究  

Study on the correlation between MP-DNA load,immune inflammatory indexes in bronchoalveolar lavage fluid of children with mycoplasma pneumonia and therapeutic effects

作　　者：庞卫花[1] 刘永涛[2] 曹智丽[3] 李金巍 陈珊[1] 林晓燕[4] 杨敬芳[1] PANG Weihua;LIU Yongtao;CAO Zhili(Department of Clinical Laboratory,The Second Hospital Affiliated to Hebei North College,Hebei,Zhangjiakou 075100,China;不详)

机构地区：[1]河北北方学院附属第二医院检验科,河北省张家口市075100 [2]河北北方学院附属第二医院信息科,河北省张家口市075100 [3]河北北方学院附属第二医院传染科,河北省张家口市075100 [4]河北北方学院附属第二医院儿科,河北省张家口市075100

出　　处：《河北医药》2020年第6期857-860,共4页Hebei Medical Journal

基　　金：张家口市科学技术研究与发展攻关项目(编号:1821031D)。

摘　　要：目的观察支原体肺炎(MPP)患儿肺泡灌洗液(BALF)中MP-DNA载量、免疫炎性指标变化及与治疗效果的关系。方法选取2013年10月至2016年6月诊治的MPP患儿75例,分为轻症MPP组(n=35)和重症MPP组(n=40),另选取30例健康体检儿童为对照组。检测3组BALF中MP-DNA载量、MP-DNA阳性率、细胞含量、细胞因子(IL-4、IL-17、IL-18、IFN-α)、sB7-H3、T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、免疫球蛋白(IgA、IgG、IgM)变化。结果不同程度MPP患儿BALF中MP-DNA载量、MP-DNA阳性率、中性粒细胞百分比、IL-4、IL-17、IL-18、IFN-α、sB7-H3、CD8+均明显高于对照组,巨噬细胞百分比、CD3+、CD4+、CD4+/CD8+、IgA、IgG、IgM均明显低于对照组(P<0.05)。治疗后MPP患儿BALF中MP-DNA载量、MP-DNA阳性率、中性粒细胞百分比、IL-4、IL-17、IL-18、IFN-α、sB7-H3、CD8+均明显低于治疗前,巨噬细胞百分比、CD3+、CD4+、CD4+/CD8+、IgA、IgG、IgM均明显高于治疗前(P<0.05)。结论MPP患儿BALF中MP-DNA载量、免疫炎性指标表达异常,且与病情严重程度密切相关,可作为判断疾病治疗效果及预后的参考依据。Objective To investigate the correlation between MP-DNA load,immune inflammatory indexes in bronchoalveolar lavage fluid(BALF)of children with mycoplasma pneumonia(MPP)and therapeutic effects.Methods A total of 75 children patients with MPP who were enrolled in the study,who were divided into mild case group(n=35)and severe case group(n=40),moreover,the other 30 healthy children were enrolled as control group.The MP-DNA load in BALF,the positive rate of MP-DNA,the percentages of the immune cells,cytokines levels including IL-4,IL-17,IL-18 and IFN-α,and sB7-H3,T lymphocyte subsets including CD3+,CD4+,CD8+,CD4+/CD8+as well as immune globulin(IgA,IgG,IgM)were detected and compared between the two groups.Results The MP-DNA load in BALF,the positive rate of MP-DNA,the percentages of the immune cells,cytokines levels including IL-4,IL-17,IL-18 and IFN-α,and sB7-H3,T lymphocyte subsets including CD3+,CD4+,CD8+,CD4+/CD8+in the two case groups were significantly higher than those in control group,however,the percentage of macrophages,CD3+,CD4+,CD4+/CD8+,IgA,IgG and IgM in the two case groups were significantly lower than those in control group(P<0.05).After treatment,the MP-DNA load in BALF,the positive rate of MP-DNA,the percentages of the immune cells,cytokines levels including IL-4,IL-17,IL-18 and IFN-α,and sB7-H3,T lymphocyte subsets including CD3+,CD4+,CD8+,CD4+/CD8+in the two case groups were significantly lower than those before treatment,however,the percentage of macrophages,CD3+,CD4+,CD4+/CD8+,IgA,IgG and IgM in the two case groups were significantly higher than those before treatment(P<0.05).Conclusion The MP-DNA load,immune inflammatory indexes in BALF of children with MPP are abnormally expressed,which are closely correlated with the severity of disease,which can be regarded as the reference indexes for evaluating the therapeutic effects and prognosis of patients.

关 键 词：支原体肺炎 支气管肺泡灌洗液 免疫细胞 

分 类 号：R725.631[医药卫生—儿科]