儿童肺泡灌洗液肺炎支原体DNA载量与免疫炎症指标的相关性分析  

Correlation between DNA load of Mycoplasma pneumoniae in bronchoalveolar lavage fluid and immunoinflammatory markers in children

作　　者：钟海琴 殷荣 蒋鲲 顾浩翔 董晓艳 ZHONG Haiqin;YIN Rong;JIANG Kun;GU Haoxiang;DONG Xiaoyan(Department of Pulmonology,Shanghai Children’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200062,China)

机构地区：[1]上海市儿童医院(上海交通大学医学院附属儿童医院)呼吸科,上海200062

出　　处：《上海医学》2024年第7期428-432,共5页Shanghai Medical Journal

基　　金：上海市卫生健康委员会科研项目(202340070)。

摘　　要：目的 探讨肺炎支原体肺炎(MPP)患儿肺泡灌洗液肺炎支原体DNA (MP-DNA)载量与免疫炎症指标的相关性。方法 采用回顾性病例对照研究。选取2021年8月—2023年7月在上海市儿童医院呼吸科病房住院诊断为MPP,并行支气管镜检查伴肺泡灌洗治疗的196例患儿。根据肺泡灌洗液(BALF)中MP-DNA载量将患儿分为高载量组64例(MP-DNA拷贝数≥10~6/mL)、低载量组85例(MP-DNA拷贝数为500~<10~6/mL)和阴性组47例(MP-DNA拷贝数<500/mL),比较三组患儿的一般情况、临床症状、外周血实验室检查、BALF常规细胞学检查、BALF细胞因子水平。采用Pearson检验进行MP-DNA载量与免疫炎症指标的相关性分析。结果 高载量组患儿的入院前发热天数和住院天数均显著长于阴性组(P值均<0.05)。高载量组和低载量组患儿ESR、D-二聚体、IgA、CD3%均显著高于阴性组(P值均<0.05)。高载量组患儿血小板显著低于低载量组和阳性组,血IgE显著高于低载量组和阳性组(P值均<0.05)。高载量组和低载量组患儿BALF中白细胞数、中性粒细胞比例、单核细胞比例均显著高于阴性组(P值均<0.05)。高载量组患儿BALF中IL-6、IL-1β、IL-10、IFN-γ、IL-8、TNF-α均显著高于低载量组和阴性组(P值均<0.05)。MPP患儿急性期BALF中IL-5、IL-6、IL-1β、IL-10、TNF-α、白细胞数均与MP-DNA载量呈正相关性(r=0.163、0.527、0.362、0.398、0.439、0.388,P值均<0.05)。结论 MP感染后患儿存在炎症反应及免疫功能紊乱,BALF中MP-DNA载量与炎症细胞因子水平具有相关性,可作为评估肺部炎症严重程度的参考依据。Objective To investigate the correlation between the load of Mycoplasma pneumoniae DNA(MP-DNA)in bronchoalveolar lavage fluid(BALF)and immunoinflammatory markers in children with mycoplasma pneumoniae pneumonia(MPP).Methods In this retrospective case-control study,196 children who were admitted to Shanghai Children's Hospital from August 2021 to July 2023 and underwent bronchoscopy and alveolar lavage for MPP were selected as study objects.According to the MP-DNA load in BALF,the children were divided into high load group(n=64,MP-DNA load≥106 copies/mL),low load group(n=85,500≤MP-DNA load<106 copies/mL),and negative group(n=47,MP-DNA load<500 copies/mL).The general information,clinical symptoms,laboratory examination result,BALF routine cytologic examination result and BALF cytokine levels of the three groups were compared.Pearson test was used to investigate the correlation between MP-DNA load and immunoinflammatory markers.Results The fever time before admission and hospital stay in the high load group were significantly longer than those in the negative group(all P<0.05).ESR,D-dimer,IgA and CD3%in the high load group and low load group were significantly higher than those in the negative group(all P<0.05).The children in the high load group had lower platelet level and higher IgE level than those in the low load group and the negative group(all P<0.05).The white blood cell count,neutrophil ratio and monocyte ratio in BALF in the high load group and low load group were significantly higher than those in the negative group(all P<0.05).The levels of IL-6,IL-1β,IL-10,IFN-γ,IL-8 and TNF-αin BALF in the high load group were significantly higher than those in the low load group and negative group(all P<0.05).IL-5,IL-6,IL-1β,IL-10,TNF-αand leukocyte count were significantly positively correlated with MP-DNA load in BALF in acute stage of MPP in these children(r=0.163,0.527,0.362,0.398,0.439,0.388,all P<0.05).Conclusion Children have inflammatory response and immune dysfunction after MP infection.MP-DNA load i

关 键 词：肺炎支原体 肺泡灌洗液 MP-DNA载量 儿童 

分 类 号：R725.6[医药卫生—儿科]