摘要
目的探讨肺炎支原体肺炎（mycoplasma pneumoniae pneumonia，MPP）患儿血清细胞因子水平的变化及临床意义。方法选择2008年1月至2009年12月我院儿内科收治的MPP患儿239例为MPP组，根据病情的严重程度再分为轻症MPP组（n=152）和重症MPP组（n=87）。选择同期收治的急性支气管肺炎患儿263例为非MPP组。选择同期在儿外科住院的疝气和包皮过长择期手术患儿共50例作为对照组。所有肺炎患儿均于入院第1天进行肺炎支原体抗体检测和细胞因子[肿瘤坏死因子（TNF）-α、γ干扰素（IFN-γ）、白细胞介素（IL）-1β、IL-4、IL-6]检测，患儿经治疗感染恢复期重新留取血清复查以上指标；对照组留取1次血清，检测细胞因子水平。结果MPP组和非MPP组患儿血清TNF-α、IL-1β、IL-6水平均高于对照组（P〈0．01）；而IFN-γ、IL-4水平3组间比较差异无统计学意义（P〉0．05）；MPP组血清IFN-γ、IL-1β水平及IFN-γ／IL-4比值高于非MPP组（P〈0．01）；MPP组恢复期TNFα、IL-1β、IL-6水平和IFN-γ／IL-4比值较急性期明显降低（P〈0．001，P〈0．05）；重症MPP组血清TNF-γ、IL-1β水平及IFN-γ／IL-4比值明显高于轻症MPP组（P〈0．01）。结论MPP患儿存在免疫功能紊乱，血清中TNF-α、IL-1β、IL-6水平及IFN-γ/IL-4比值与病情严重程度相关，可用来评估病情。
Objeαive To investigate the changes of serum cytokines in children with mycoplasma pneumoniae pneumonia （MPP）. Methods A total of 239 children with MPP hospitalized in our department from Jan 2008 to Dec 2009 served as MPP group ,which were redivided into mild MPP group （n = 152） and severe MPP group （ n = 87 ）. Two hundred and sixty-three acute bronchopneumonia children without MPP infeαion served as non-MPP group. Fifty cases who would undergo hernia and phimosis eleαive surgery in ped-iatric surgery department served as control group. All children with pneumonia were deteαed mycoplasma pneumoniae antibodies and cytokines （TNF-α, IFN-γ, IL-1β, IL-4, IL-6） of serum in the first day of hospi-talization and recovery period. Children in control group were deteαed the level of cytokines only once. Results Serum levels of TNF-α,IL-1β,IL-6 in MPP group and non-MPP group were higher than those in control group （ P 〈 0. 01 ）. No significant differences of IFN-γ and IL-4 levels were found among three groups （P 〉 0. 05 ）. Compared with non-MPP group, the levels of IFN-γ, IL-1β and IFN-γ/IL-4 were higher in MPP group （P 〈 0.01 ）. The levels of TNF-α, IL-1β, IL-6, and IFN-γ/IL-4 were significantly decreased in the recovery period of MPP （ P 〈 0. 001, P 〈 0.05 ）. The levels of TNF-a, 1L-1β and IFN-γ/IL-4 in severe MPP children were higher than those in mild MPP children （ P 〈 0. 01 ）. Conclusion The immunologic funαion of MPP children is unbalanced. The serum levels of TNF-α, IL-1β, IL-6, and IFN-γIL-4 are correlated with severity of MPP, which help to evaluate the state of MPP.
出处
《中国小儿急救医学》
CAS
2011年第6期504-507,共4页
Chinese Pediatric Emergency Medicine
