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目的探讨难治性肺炎支原体肺炎(RMPP)血清总IgE水平与临床表现的相关性及对RMPP患儿早期识别的意义。方法选取天津市儿童医院呼吸二科2016年1-10月收治的临床确诊为RMPP患儿60例检测血清IgE水平,根据IgE水平将患儿分为IgE升高组40例(试验组)和IgE正常组20例(对照组),分析两组患儿临床表现、实验室指标、影像学和纤维支气管镜检查结果的差异。结果试验组患儿较对照组患儿发生一过性喘息、血清CRP>40mg/L的比例较高,胸部影像学上发生多叶病变和胸腔积液的比例较高,差异均有统计学意义(P<0.05);同时试验组患儿肺泡灌洗液出现MP-DNA高拷贝(>106copies/ml)的比例较高,差异有统计学意义(P<0.05)。结论血清总IgE水平升高对RMPP患儿早期识别具有一定的临床意义,RMPP患儿IgE水平升高可成为重症肺炎支原体肺炎的预警因素之一。
Objective To investigate the correlation between serum total IgE level and clinical manifestations in patients with refractory Mycoplasma pneumoniae pneumonia (RMPP) and its significance in early identification of children with RMPP. Methods Totally 60 children with RMPP admitted to Department of Respiratory Diseases, Children’s Hospital of Tianjin from January to October 2016 were enrolled in the study. Serum IgE levels were measured in 40 children (experimental group) and IgE 20 cases of normal group (control group), analysis of two groups of children with clinical manifestations, laboratory parameters, imaging and bronchoscopy results differences. Results Compared with control group, the children in experimental group had a transient wheezing, the serum CRP> 40mg / L was higher, the incidence of multi-leaf disease and pleural effusion in chest was higher, the differences were statistically significant (P <0.05). At the same time, the proportion of high-copy MP-DNA (> 106copies / ml) in the alveolar lavage fluid of the experimental group was higher than that of the control group (P <0.05). Conclusion The increase of serum total IgE level has some clinical significance in the early identification of RMPP children. Elevated IgE levels in RMPP children may be one of the early warning factors of severe Mycoplasma pneumoniae pneumonia.