摘要
目的 探讨儿童肺炎支原体肺炎(MPP)肺外并发症与外周血细胞因子、免疫球蛋白E(IgE)的相关性,以指导临床诊断、治疗及判断病情。方法 回顾性分析2018年7月-2019年6月在浙江省台州医院儿科病房住院治疗的MPP患儿205例,并根据是否有肺外并发症分为肺外并发症组(45例)和无肺外并发症组(160例),均于入院后24 h内检测外周血部分Th1、Th2细胞因子(IL-2、IL-4、IL-6、IL-10、IFN-γ、TNF-α)及IgE。结果 肺外并发症组的住院时间为(9.75±4.74)d,无肺外并发症组为(8.02±3.98)d,前者住院时间明显长于后者,差异有统计学意义(P<0.05);既往有哮喘病史者肺外并发症发生率达20%,无哮喘病史者肺外并发症发生率为8.8%,所以有哮喘病史者更容易出现肺外并发症;两组年龄、性别及肺炎类型比较,差异均无统计学意义(P>0.05);肺外并发症组IL-6平均为28.60 pg/ml, IL-10为(9.17±5.23)pg/ml, IFN-γ为(17.58±8.71)pg/ml, IgE平均为110.00 IU/ml,而无肺外并发症组IL-6平均为6.60 pg/ml, IL-10为(5.45±1.98)pg/ml, IFN-γ为(4.98±4.50)pg/ml, IgE平均为34.85 IU/ml,肺外并发症组IL-6水平明显高于无肺外并发症组,差异有统计学意义(P<0.05),而两组IL-2、IL-4、TNF-α比较,差异均无统计学意义(均P>0.05)。结论 有肺外并发症的MPP患儿住院时间更长,更容易进展为难治性MPP。Th1/Th2细胞因子的失衡与MPP肺外并发症发病机制密切相关,血清总IgE、IFN-γ水平的升高对MPP患儿肺外并发症的早期识别具有一定的临床意义。
Objective To assess the association of cytokines and IgE with extrapulmonary complications of mycoplasma pneumoniae in children,in order to guide clinical diagnosis,treatment and judgment of the disease progress.Methods This is a retrospective analysis.A total of 205 children with MPP who were hospitalized in pediatric of Taizhou Hospital in Zhejiang Province from July 2018 to June 2019 were enrolled.They were divided into extrapulmonary complications group(45 cases)and non-extrapulmonary complications group(160 ca-ses),IFN-,IL-4,and IgE were detected within 24 hours after admission.Results The duration of hospitalization in the extrapulmonary complications group was(9.75±4.74)days and in the non-extrapulmonary complications group(8.02±3.98)days,which were significant-ly longer than the duration in the former group,with statistical significance(P<0.05);the incidence of extrapulmonary complications was 20%in those with a history of asthma,and 8.8%in those without a history of asthma,so that those with a history of asthma were more likely to have extrapulmonary complications;the difference between the two groups in age,sex and type of pneumonia was not statistically signifi-cant(P>0.05);the interleukin-6 averaged 28.60 pg/ml,interleukin-10 averaged(9.17±5.23)pg/ml,IFN-averaged(17.58±8.71)pg/ml,and IgE averaged 110.00 IU/ml,while interleukin-6 averaged 6.60pg/ml,interleukin-10 averaged(5.45±1.98)pg/ml,IFN-averaged(4.98±4.50)pg/ml,and IgE averaged 34.85 IU/ml,and interleukin-6 levels in the non-extrapulmonary complications group were significantly higher than those in the non-extrapulmonary complications group,with statistical significance(P<0.05),and the difference between the two groups in interleukin-6,interleukin-4,and TNF-αaveraged 10.Conclusion Children with MPP with extrapul-monary complications are more likely to progress to refractory MPP with longer hospital stay.The imbalance of Thl/Th2 cytokines is closely related to the pathogenesis of extrapulmonary complications in MPP,and the increase of total serum IgE and IFN-levels has some clinical significance in the early recognition of extrapulmonary complications in children with MPP.
作者
周芳芳
陈玲玲
周挺敏
ZHOU Fang-fang;CHEN Ling-ling;ZHOU Ting-min(Department of Pediatrics,Taizhou Hospital of Zhejiang Province,Taizhou,Zhejiang 317000,China)
出处
《中国妇幼保健》
CAS
2024年第15期2850-2853,共4页
Maternal and Child Health Care of China
基金
浙江省中国科学技术项目(20ywb22)。
