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目的:测定肺炎支原体肺炎(MPP)患儿急性期及恢复期的免疫功能及炎症因子的水平,探讨其临床意义。方法:选取我院2012年收治的MPP患儿56例,测定急性期及恢复期免疫球蛋白(Ig M、Ig G、Ig A)、补体(C3、C4)、细胞因子(TNF-α、TGF-β1、IL-2、IL-6、IL-8、IL-10、IL-13)及T细胞亚群(CD3+、CD4+、CD8+)的水平,同时选取我院同期体检健康的儿童56例为对照组进行研究。结果:MPP急性期血清Ig M及补体水平升高,进入恢复期后下降,且恢复期C4水平仍高于正常;急性期Ig G水平变化不明显,进入恢复期后升高;急性期和恢复期Ig A水平均降低。MPP急性期血清TNF-α、TGF-β1、IL-6、IL-10、IL-13水平升高,IL-2降低,进入恢复期后逐渐恢复正常;急性期IL-8水平变化不明显,进入恢复期后升高。MPP急性期CD3+、CD4+水平降低,CD8+升高,CD4+/CD8+降低,进入恢复期后逐渐恢复正常。结论:婴幼儿MPP急性期和恢复期均存在体液免疫及细胞免疫功能紊乱,炎症因子表达异常,提示MP感染可引起机体炎症反应及免疫失调,观察炎症因子的变化可预测病情及预后,在对症治疗同时进行免疫调节治疗可缩短病程,提高康复率。
Objective: To determine the levels of immune function and inflammatory cytokines in acute and convalescent children with Mycoplasma pneumoniae pneumonia (MPP) and to discuss its clinical significance. Methods: Fifty-six children with MPP admitted to our hospital in 2012 were enrolled in this study. Immunoglobulin (Ig M, Ig G, Ig A), complement (C3, C4), cytokines (TNF- The levels of CD3 +, CD4 +, CD8 + were measured in 56 healthy children at the same period of our hospital Control group to study. Results: The levels of serum IgM and complement in the acute phase of MPP increased and decreased after entering the recovery phase, and the level of C4 in the recovery phase was still higher than normal. The levels of Ig G in the acute phase were not significantly changed and increased after the recovery phase. IgA levels were reduced. The levels of TNF-α, TGF-β1, IL-6, IL-10 and IL-13 in acute phase of MPP were increased and IL-2 was decreased and gradually returned to normal after recovery. In acute phase, the level of IL- After entering the recovery period increased. In the acute phase of MPP, the levels of CD3 + and CD4 + decreased, CD8 + increased and CD4 + / CD8 + decreased, and gradually returned to normal after recovery. CONCLUSION: Both humoral and cellular immune dysfunction and inflammatory cytokines are present in acute and convalescent MPP of infants and young children, suggesting that MP infection can cause inflammatory and immune disorders in MPP. The changes of inflammatory cytokines can predict the disease and prognosis. Treatment while immunomodulatory treatment can shorten the course of the disease and improve the recovery rate.