摘要
目的探讨重症肺炎支原体肺炎(SMPP)患儿咽拭子、肺泡灌洗液(BALF)中肺炎支原体DNA (MP-DNA)复制水平与病情的相关性。方法 44例行支气管肺泡灌洗术的SMPP患儿为研究对象,分别在急性期和恢复期检测相关血清细胞因子水平及咽拭子MP-DNA复制倍数,并检测急性期BALF中白细胞介素(IL)-18水平及MP-DNA复制倍数。并按照病程中是否出现呼吸衰竭需要机械通气分为机械通气组(n=19)与非机械通气组(n=25),比较两组患儿肺泡灌洗液中MP-DNA复制倍数。结果与恢复期相比,SMPP患儿在急性期时,血清C反应蛋白、红细胞沉降率、乳酸脱氢酶、IL-1、IL-6、IL-8、IL-18水平显著增高(P < 0.05)。急性期咽拭子与BALF的MP-DNA复制倍数呈显著正相关(r=0.613,P < 0.05);BALF中MP-DNA复制倍数与外周血及BALF的IL-18水平呈正相关(分别r=0.613、0.41,均P < 0.05)。机械通气组BALF中MP-DNA复制倍数高于非机械通气组,且全身激素治疗时间明显长于非机械通气组,血清乳酸脱氢酶、IL-18及BALF中WBC总数、IL-18水平也更高(P < 0.05)。结论 SMPP患儿急性期咽拭子与BALF MP-DNA复制水平可作为病情评估的参考。
Objective To study the correlation of Mycoplasma pneumoniae DNA (MP-DNA) replication level in throat swab and bronchoalveolar lavage fluid (BALF) with disease severity in children with severe Mycoplasma pneumoniae pneumonia (SMPP). Methods A total of 44 children with SMPP who underwent bronchoalveolar lavage were enrolled as subjects. The serum levels of cytokines and MP-DNA replication times in throat swab were measured in the acute stage and the recovery stage, and the levels of interleukin (IL)-8 and MP-DNA replication times in BALF were measured in the acute stage. According to whether mechanical ventilation was needed for respiratory failure, the children were divided into a mechanical ventilation group (n=19) and a non-mechanical ventilation group (n=25), and the two groups were compared in MP-DNA replication times in BALF. Results For the children with SMPP, serum levels of C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase, IL-1, IL-6, IL-8, and IL-18 in the acute stage were significantly higher than those in the recovery stage (P < 0.05). In the acute stage, MP-DNA replication times in throat swab were positively correlated with those in BALF (r=0.613, P < 0.05), and MP-DNA replication times in BALF were positively correlated with IL-18 levels in peripheral blood and BALF (r=0.613 and 0.41 respectively, P < 0.05). Compared with the non-mechanical ventilation group, the mechanical ventilation group had significantly higher MP-DNA replication times in BALF, a significantly longer duration of systemic hormone treatment, significantly higher serum levels of lactate dehydrogenase and IL-18, and significantly higher white blood cell count and IL-18 level in BALF (P < 0.05). Conclusions In children with SMPP, MP-DNA replication level in throat swab and BALF can be used as a reference index for the assessment of disease severity.
作者
方柯南
王晶
倪婧雯
FANG Ke-Nan;WANG Jing;NI Jing-Wen(Pediatric Intensive Care Unit, Women and Children's Health Care Center of Luoyang, Luoyang, Henan 471000)
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2019年第9期876-880,共5页
Chinese Journal of Contemporary Pediatrics
