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目的研究肺表面活性蛋白在小儿肺炎支原体肺炎(MPP)血清和支气管肺泡灌洗液(BALF)中的变化及意义。方法根据肺CT结果将47例MPP患儿分为两组:单侧病变组(n=32)和双侧病变组(n=15)。采用ELISA法检测两组患儿BALF和血清中肺表面活性蛋白A、B、C、D(SP-A、B、C、D)的含量。血清与BALF中SP-A、B、C、D含量的相关性采用Spearman秩相关分析。结果两组患儿中,主病变侧或病变侧BALF中SP-A、B、C、D含量显著高于次病变侧或健侧BALF和血清中SP-A、B、C、D含量(P<0.01)。单侧病变组患儿血清中SP-A、B、C含量显著低于健侧BALF中含量(P<0.01或0.05),而血清中SP-D含量与健侧BALF中SP-D含量差异无统计学意义(P>0.05)。双侧病变组患儿血清中SP-A、B、C、D含量与次病变侧BALF中SP-A、B、C、D含量相比,差异无统计学意义(P>0.05)。Spearman秩相关分析显示,双侧病变组患儿中血清SP-D含量与主病变侧BALF中SP-D含量呈密切正相关(P<0.01)。结论血清中SP-D可作为反映小儿社区获得性肺炎肺组织感染损伤严重程度的生化指标。
Objective To study the changes and significance of pulmonary surfactant proteins in children with Mycoplasma pneumoniae pneumonia (MPP) and bronchoalveolar lavage fluid (BALF). Methods According to pulmonary CT findings, 47 MPP children were divided into two groups: unilateral lesion group (n = 32) and bilateral lesion group (n = 15). The contents of pulmonary surfactant protein A, B, C, D (SP-A, B, C, D) in BALF and serum of the two groups were detected by ELISA. Serum and BALF SP-A, B, C, D content correlation Spearman rank correlation analysis. Results The contents of SP-A, B, C and D in the BALF of the main lesion or lesion side of the two groups were significantly higher than those of the lesion side and the contralateral side <0.01). The contents of SP-A, B and C in the serum of unilateral lesion group were significantly lower than those in the contralateral BALF (P <0.01 or 0.05), while the contents of SP-D in serum and SP-D in contralateral BALF Statistical significance (P> 0.05). There were no significant differences in the levels of SP-A, B, C and D in the serum of children with bilateral lesion compared with the levels of SP-A, B, C and D in the lesion side of the lesion (P> 0.05). Spearman rank correlation analysis showed that there was a positive correlation between serum SP-D level and SP-D level in the main lesion side of children with bilateral lesion (P <0.01). Conclusion Serum SP-D can be used as a biochemical index to reflect the severity of lung infection in children with community-acquired pneumonia.