摘要
目的探究肺炎支原体(MP)感染与支气管哮喘患儿发病的关系及其对患儿免疫球蛋白E(IgE)、细胞因子的影响。方法选取2018年4月至2020年2月榆林市第一医院收治的200例支气管哮喘患儿设为试验组,同期200例上呼吸道感染患儿(非MP感染、非哮喘)设为上感组,200例健康体检儿童设为健康组。测定以上三组儿童的MP滴度、阳性率和试验组不同病程患儿的MP滴度、阳性率,应用Logistic回归分析分析支气管哮喘发病的影响因素,比较试验组MP阳性、阴性和不同MP程度患儿的血清IgE、细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-17(IL-17)]的表达水平,并应用Spearman相关性分析法分析MP表达与支气管哮喘患儿Ig E、细胞因子水平间的关联性。结果试验组患儿MP滴度及阳性率分别为71.09±8.17、44.50%,明显高于上感组的21.68±4.62、14.50%及健康组的20.08±2.16、4.50%,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,MP感染为支气管哮喘发病的重要危险因素(P<0.05);试验组疾病处于急性期患儿MP滴度及阳性率分别为105.69±10.25、61.11%,明显高于缓解期患儿的30.47±5.08、25.00%,差异均有统计学意义(P<0.05);试验组MP阳性患儿血清Ig E、TNF-α、IL-4、IL-17水平明显高于阴性患儿,差异均有统计学意义(P<0.05);试验组MP感染重症患儿血清Ig E、TNF-α、IL-4、IL-17水平明显高于轻症患儿,差异均有统计学意义(P<0.05);MP表达与支气管哮喘患儿Ig E、TNF-α、IL-4、IL-17水平呈显著正相关(r=0.682、0.706、0.795、0.517,P<0.05)。结论MP感染与小儿支气管哮喘发生、进展具有密切关系,且其表达与患儿Ig E、细胞因子水平密切相关,可能为导致气道炎症及免疫紊乱的重要原因。
Objective To investigate the relationship between Mycoplasma pneumoniae(MP)infection and the onset of bronchial asthma and its effect on immunoglobulin E(IgE)and cytokines in children.Methods Two hundred children with bronchial asthma admitted to the First Hospital of Yulin City from April 2018 to February 2020 were selected as the experimental group,200 children with upper respiratory tract infection(non-MP infection,non-asthma)were enrolled as the upper infection group,and 200 healthy children with physical examination were selected as the healthy group.The MP titers and positive rates were detected in the three groups and in children with different course of disease in the experimental group.Logistic regression analysis was used to explore the influencing factors of bronchial asthma.The expression of serum Ig E,cytokines(tumor necrosis factor-α[TNF-α],interleukin-4[IL-4],interleukin-17[IL-17])in children with MP positive,negative and different MP degrees in the experimental group were observed,and the Spearman correlation analysis was used to explore the correlation between MP expression and Ig E and cytokines(TNF-α,IL-4,IL-17)levels in children with bronchial asthma.Results The MP titer and positive rate of the experimental group were 71.09±8.17 and 44.50%,which were significantly higher than 21.68±4.62,14.50%of the upper infection group and20.08±2.16,4.50%of the healthy group(P<0.05).Logistic regression analysis showed that MP infection was an important risk factor for bronchial asthma(P<0.05).The MP titers and positive rates of children in the experimental group in the acute phase were 105.69±10.25 and 61.11%,which were significantly higher than 30.47±5.08 and 25.00%in the remission phase(P<0.05).The serum Ig E,TNF-α,IL-4,and IL-17 levels of MP positive children in the experimental group were significantly higher than those of negative children,and the difference was statistically significant(P<0.05).Serum Ig E,TNF-α,IL-4,IL-17 levels of severely infected children with MP infection in the experimental group were significantly higher than those of mildly ill children,and the difference was statistically significant(P<0.05).The expression of MP was significantly positively correlated with Ig E and cytokines(TNF-α,IL-4,IL-17)levels in children with bronchial asthma(r=0.682,0.706,0.795,0.517,P<0.05).Conclusion MP infection is closely related to the occurrence and progression of bronchial asthma in children,and its expression is closely related to Ig E and cytokine levels in children,which may be an important cause of airway inflammation and immune disorders.
作者
雷东红
葛雯雯
闫凡
迟建秀
LEI Dong-hong;GE Wen-wen;YAN Fan;CHI Jian-xiu(Department of Pediatrics,the First Hospital of Yulin City,Yulin 718000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第14期1843-1846,共4页
Hainan Medical Journal
基金
陕西省自然科学基础研究计划项目(编号:2018ZDXM-SF-040)。
