摘要
目的对儿童重症肺炎支气管肺泡灌洗液(BALF)进行病原学分析及疾病预后的分析。方法本研究选取2019年3月-2020年12月在我院儿科住院并进行肺泡灌洗治疗的40例重症肺炎患儿作为研究对象。通过对这些患儿在感染急性期肺泡灌洗液中的细菌、真菌、肺炎支原体等进行病原学检查以及T淋巴细胞亚群的检测,了解台山地区儿童重症肺炎病原体情况及耐药性、T淋巴细胞亚群与疾病严重程度、预后评估的关系。结果BALF病原学检测结果分析中,肺炎支原体27例,肺炎支原体+肺炎链球菌5例,肺炎支原体+中间葡萄球菌2例,肺炎支原体+铅黄肠球菌1例,肺炎支原体+嗜麦芽假单胞菌2例,病原菌阴性3例;本组病例血清T细胞亚群检测结果显示:大部分病例CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平有不同程度的下降。其中CD3^(+)水平下降的有6例,CD4^(+)水平下降的有16例,CD8^(+)水平下降的有17例,CD4^(+)、CD8^(+)水平同时下降的有14例,CD3^(+)、CD4^(+)、CD8^(+)水平同时下降的有4例;BALF细胞总数(3673.1±377.9)×10^(6)/L,巨噬细胞比例(23.6±17.6)%,淋巴细胞(22.1±16.2)%,中性粒细胞(46.5±24.8)%。结论病原学分析儿童重症肺炎BALF的主要病原菌为肺炎支原体,血清T细胞亚群检测大多表现为CD4^(+)、CD8^(+)水平下降。
Objective To analyze the etiology of bronchoalveolar lavage fluid and prognosis of children with severe pneumonia.Methods In this study,40 children with severe pneumonia who were hospitalized in the pediatrics department of our hospital and underwent alveolar lavage treatment from March 2019 to December 2020 were selected as the research objects.Through the detection of pathogens such as bacteria,fungi,Mycoplasma pneumoniae and T lymphocyte subsets of these children in the acute phase of infection,we can understand the pathogens and drug resistance of children with severe pneumo-nia in Taishan area and the relationship among drug resistance,T lymphocyte subsets and disease severity and prognosis as-sessment.Results In the analysis of the BALF pathogenic test results,there were 27 cases with Mycoplasma pneumoniae,5 cases with Mycoplasma pneumoniae+Streptococcus pneumoniae,2 cases with Mycoplasma pneumoniae+Staphylococcus intermedius,1 case with Mycoplasma pneumoniae+Enterococcus casseliflavus,2 cases with Mycoplasma pneumoniae+Pseudomonas maltophilia and 3 cases were pathogenic bacteria negative.The test results of serum T cell subsets of these cases showed that most of the cases had different degrees of decline in the levels of CD3^(+),CD4^(+),CD8^(+) and CD4^(+)/CD8^(+).Among them,CD3^(+) levels decreased in 6 cases,CD4^(+) levels decreased in 16 cases,CD8^(+) levels decreased in 17 cases,CD4^(+) and CD8^(+) levels decreased in 14 cases,and CD3^(+),CD4^(+),and CD8^(+) levels decreased in 4 cases;total cell number of BALF was(3673.1±377.9)×10^(6)/L,the proportion of macrophages was(23.6±17.6)%,lymphocytes had(22.1±16.2)%,and neutrophils had(46.5±24.8)%.Conclusions Pathogenic analysis showed that the main pathogen of BALF in children with severe pneumonia is Mycoplasma pneumoniae,and the detection of serum T cell subsets mostly showed a de-crease in CD4^(+) and CD8^(+) levels.
作者
陈婷女
梁慕琼
梁亮
CHEN Tingnv;LIANG Muqiong;LIANG Liang(Department of Pediatrics,Taishan Maternal and Child Health Hospital,Jiangmen 529200,China)
出处
《广州医药》
2022年第3期53-56,共4页
Guangzhou Medical Journal
基金
江门市科学技术局(2019020301140005088)。
关键词
儿童
重症肺炎支气管肺泡灌洗液
病原学分析
疾病预后
children
severe pneumonia bronchoalveolar lavage fluid
pathogenic analysis
disease prognosis
