肺炎支原体肺炎患儿血清MICA、OPN水平及其与反复呼吸道感染的相关性研究  

Serum levels of MICA and OPN in children with Mycoplasma pneumoniae pneumonia and their correlation with recurrent respiratory tract infection

作　　者：梁文婷 霍开明[1] 古裕鸟 吴小红 LIANG Wenting;HUO Kaiming;GU Yuniao;WU Xiaohong(The Second Department of Pediatrics,the Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570000,China)

机构地区：[1]海南医学院第二附属医院儿科二区,海南海口570000

出　　处：《检验医学与临床》2024年第13期1870-1874,共5页Laboratory Medicine and Clinic

基　　金：海南省卫生计生行业科研项目(20A200095)。

摘　　要：目的探究肺炎支原体肺炎患儿血清主要组织相容性复合物Ⅰ链相关基因A(MICA)、骨桥蛋白(OPN)水平及其与反复呼吸道感染的相关性。方法选取该院2019年3月至2021年3月收治的肺炎支原体肺炎患儿106例作为研究组,另选取同期于该院进行体检的健康儿童106例作为对照组,根据肺炎支原体肺炎患儿是否发生反复呼吸道感染分为反复呼吸道感染发生组和反复呼吸道感染未发生组;使用全自动微生物鉴定系统和纸片扩散试纸进行病原菌检测以及耐药性试验;血清MICA、OPN水平检测采用酶联免疫吸附试验;采用多因素Logistic回归分析影响肺炎支原体肺炎反复呼吸道感染发生的危险因素;绘制受试者工作特征(ROC)曲线分析血清MICA、OPN单独及联合检测对肺炎支原体肺炎患儿发生反复呼吸道感染的预测价值。结果106例肺炎支原体肺炎患儿共分离出116株菌株,其中革兰阴性菌77株(66.38%),包括流感嗜血杆菌29株(25.00%),肺炎克雷伯菌17株(14.66%),鲍曼不动杆菌14株(12.07%),铜绿假单胞菌8株(6.90%),阴沟肠杆菌6株(5.17%),其他菌3株(2.59%);革兰阳性菌39株(33.62%),包括金黄色葡萄球菌16株(13.79%),表皮葡萄球菌10株(8.62%),肠球菌6株(5.17%),溶血葡萄球菌5株(4.31%),其他菌2株(1.72%)。流感嗜血杆菌耐药率较高的为头孢哌酮,占75.86%,肺炎克雷伯菌耐药率较高的为氨苄西林,占88.24%。16株金黄色葡萄球菌中,对红霉素耐药12株(75.00%),对环丙沙星耐药8株(50.00%),对四环素耐药6株(37.50%),对苯唑西林耐药4株(25.00%),对克林霉素耐药2株(12.50%),未发现对万古霉素和利奈唑胺耐药的金黄色葡萄球菌。研究组血清MICA、OPN水平均明显高于对照组,差异均有统计学意义(P<0.05)。46例患儿发生反复呼吸道感染,60例患儿未发生反复呼吸道感染。反复呼吸道感染发生组使用药物不当比例,血清MICA、OPN水平均明显高于反复呼吸道感染未发�Objective To investigate the serum levels of major histocompatibility complexⅠchain-related gene A(MICA)and osteopontin(OPN)in children with Mycoplasma pneumoniae pneumonia and their correlation with recurrent respiratory tract infection.Methods A total of 106 children with Mycoplasma pneumoniae pneumonia admitted to the hospital from March 2019 to March 2021 were selected as the study group,and 106 healthy children who underwent physical examination in the hospital during the same period were selected as the control group.According to whether Mycoplasma pneumoniae pneumonia children had recurrent respiratory tract infection,they were divided into recurrent respiratory tract infection occurrence group and recurrent respiratory tract infection non-occurrence group.The automatic microbial identification system and disk diffusion test paper were used for pathogen detection and drug resistance test.Serum MICA and OPN levels were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the risk factors of recurrent respiratory tract infection with Mycoplasma pneumoniae pneumonia.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum MICA and OPN alone and combined detection for the occurrence of recurrent respiratory tract infection of Mycoplasma pneumoniae pneumonia.Results A total of 116 strains were isolated from 106 children with Mycoplasma pneumoniae pneumonia,and 77 strains(66.38%)were Gram-negative bacteria,including 29 strains of Haemophilus influenzae(25.00%),17 strains of Klebsiella pneumoniae(14.66%),14 strains of Acinetobacter baumannii(12.07%),8 strains of Pseudomonas aeruginosa(6.90%),6 strains of Enterobacter cloacae(5.17%),and 3 strains of other bacteria(2.59%).There were 39 strains of gram-positive bacteria(33.62%),including 16 strains of Staphylococcus aureus(13.79%),10 strains of Staphylococcus epidermidis(8.62%),6 strains of Enterococcus(5.17%),5 strains of Staphylococcus haemolyticus(4.31%),and 2 strains of oth

关 键 词：肺炎支原体肺炎 主要组织相容性复合体I类链相关蛋白 骨桥蛋白 反复呼吸道感染 病原菌 

分 类 号：R725.6[医药卫生—儿科] R816.92[医药卫生—临床医学]