摘要
目的探讨肺炎支原体肺炎（mycoplasma pneumoniae pneumonia，MPP）患儿支气管肺泡灌洗液（bronchoalveolar lavage fluid，BALF）中，白细胞介素（interleukin，IL）-6、单核细胞趋化因子（monocyte chemotactic protein，MCP）-1、干扰素（interferon，IFN）-γ及T细胞亚群的水平及临床意义。
方法选取2014年10月至2016年3月在我院住院的36例肺炎患儿，按诊断标准分为难治性肺炎支原体肺炎（refractory mycoplasma pneumoniae pneumonia，RMPP）组（18例）和MPP组（18例），及同期收治的支气管异物患儿16例作为对照组。分别采用双抗体夹心ELISA法及碱性磷酸酶-抗碱性磷酸酶（APAAP）桥联酶标法测定3组患儿BALF中的IL-6、MCP-1、IFN-γ及T细胞亚群水平。
结果（1）MPP组及RMPP组急性期患儿的BALF中，CD3＋、CD8＋ T细胞水平高于对照组（P〈0.05），但两组急性期间比较差异无统计学意义（P〉0.05）。（2）RMPP组急性期IL-6水平高于对照组（P〈0.05），RMPP组及MPP组急性期IL-6水平高于恢复期（P〈0.05）。（3）RMPP组急性期及MPP组急性期IFN-γ水平均高于对照组，3组间比较差异有统计学意义（P〈0.05），且RMPP组急性期较MPP组急性期明显升高（P〈0.05），RMPP组恢复期高于MPP组恢复期。（4）RMPP组急性期及MPP组急性期MCP-1水平高于对照组（P〈0.05），且RMPP组急性期高于MPP组急性期，RMPP组恢复期高于MPP组恢复期，RMPP组急性期及MPP组急性期MCP-1水平均分别高于恢复期（P〈0.05）。
结论肺炎支原体感染后，患儿存在细胞免疫调节及功能的紊乱；IL-6、MCP-1及IFN-γ是重要的细胞因子，可能参与了MPP的发病过程，并且IFN-γ及MCP-1可作为预测MPP难治性的重要指标。
Objective To explore the levels and clinical significances of T-cell subset, interleukin （IL）-6, interferon （ IFN ）-＇y, and monocyte chemotactic protein （ MCP ）-1 in bronchoalveolar lavage fluid （BALF） of children with mycoplasma pneumoniae pneumonia（MPP）. Methods Thirty-six children with pneumonia were admitted in our hospital from October 2014 to March 2016. They were divided into refractory mycoplasma pneumoniae pneumonia （RMPP） group （ n = 18 ） and MPP group （ n = 18 ）. Sixteen cases with bronchial foreign body were selected as the control group. The levels of IL-6, MCP-1, IFN-7 and T-cell subset in BALF were detected by ELISA and alkaline phosphatase-anti-alkaline phosphatase （ APAAP ） bridging enzyme linked immunosorbent assay. Results （ 1 ） The levels of CD3 ~ and CD8 ~ T cells in BALF of MPP group and RMPP group were higher than those in the control group （ P 〈 0. 05 ）, but there were no significant differences between the two groups （ P 〉 0. 05 ）. （2） The level of IL-6 in acute phase of RMPP group was higher than that in the control group （ P 〈 0. 05 ）. The levels of IL-6 in acute phase of RMPP group and MPP group were both higher than that in recovery period （ P 〈 0. 05, respectively）. （3） The levels of IFN-γ in the acute phase of RMPP group and MPP group were higher than that in the control group, and the differences were statistically significant （ P 〈 0. 05 ）. The IFN-γ/levels in acute and recovery phases of RMPP group were both significantly higher than those in MPP group respectively（ P 〈 0. 05 ）. （4）The level of MCP-1 in BALF in control group was lower than those in the acute phase of RMPP group and MPP group （ P 〈 0. 05 ）. The level of MCP-I in RMPP acute group was significantly higher than that in MPP acute group, and higher in acute phase than those in recovery phase both in two groups （ P 〈 0. 05 ）. Conclusion There are cell immune regulation and function disorders when children are infected mycoplasma pneumoniae. IL-6, IFN-γand MCP-1 may participate in the pathogenesis of MPP, and more importantly, IFN-γ/and MCP-1 may be the important indicator to forecast the severity of MPP.
出处
《中国小儿急救医学》
CAS
2017年第11期850-854,共5页
Chinese Pediatric Emergency Medicine
基金
辽宁省临床能力建设项目（LNCCC-C02-2015）
