中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2011年
6期
504-507
,共4页
肺炎支原体肺炎%肿瘤坏死因子-α%白细胞介素4%γ干扰素%白细胞介素-6%白细胞介素-1β%儿童
肺炎支原體肺炎%腫瘤壞死因子-α%白細胞介素4%γ榦擾素%白細胞介素-6%白細胞介素-1β%兒童
폐염지원체폐염%종류배사인자-α%백세포개소4%γ간우소%백세포개소-6%백세포개소-1β%인동
Mycoplasma pneumoniae pneumonia%Tumor necrosis factor-α%Interleukin-4%Interferonγ%Interleukin-6%Interleukin-1β%Children
目的 探讨肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿血清细胞因子水平的变化及临床意义.方法 选择2008年1月至2009年12月我院儿内科收治的MPP患儿239例为MPP组,根据病情的严重程度再分为轻症MPP组(n=152)和重症MPP组(n=87).选择同期收治的急性支气管肺炎患儿263例为非MPP组.选择同期在儿外科住院的疝气和包皮过长择期手术患儿共50例作为对照组.所有肺炎患儿均于入院第1天进行肺炎支原体抗体检测和细胞因子[肿瘤坏死因子(TNF)-α、γ干扰素(IFN-γ)、白细胞介素(IL)-1β、IL-4、IL-6]检测,患儿经治疗感染恢复期重新留取血清复查以上指标；对照组留取1次血清,检测细胞因子水平.结果 MPP组和非MPP组患儿血清TNF-α、IL-1β、IL-6水平均高于对照组(P＜0.01)；而IFN-γ、IL-4水平3组间比较差异无统计学意义(P ＞0.05)；MPP组血清IFN-γ、IL-1β水平及IFN-γ/IL-4比值高于非MPP组(P＜0.01)；MPP组恢复期TNF-α、IL-1β、IL-6水平和IFN-γ/IL-4比值较急性期明显降低(P ＜0.001,P＜0.05)；重症MPP组血清TNF-a、IL-1β水平及IFN-γ、IL-4比值明显高于轻症MPP组(P＜0.01).结论 MPP患儿存在免疫功能紊乱,血清中TNF-α、IL-1β、IL-6水平及IFN-γ/IL-4比值与病情严重程度相关,可用来评估病情.
目的 探討肺炎支原體肺炎(mycoplasma pneumoniae pneumonia,MPP)患兒血清細胞因子水平的變化及臨床意義.方法 選擇2008年1月至2009年12月我院兒內科收治的MPP患兒239例為MPP組,根據病情的嚴重程度再分為輕癥MPP組(n=152)和重癥MPP組(n=87).選擇同期收治的急性支氣管肺炎患兒263例為非MPP組.選擇同期在兒外科住院的疝氣和包皮過長擇期手術患兒共50例作為對照組.所有肺炎患兒均于入院第1天進行肺炎支原體抗體檢測和細胞因子[腫瘤壞死因子(TNF)-α、γ榦擾素(IFN-γ)、白細胞介素(IL)-1β、IL-4、IL-6]檢測,患兒經治療感染恢複期重新留取血清複查以上指標；對照組留取1次血清,檢測細胞因子水平.結果 MPP組和非MPP組患兒血清TNF-α、IL-1β、IL-6水平均高于對照組(P＜0.01)；而IFN-γ、IL-4水平3組間比較差異無統計學意義(P ＞0.05)；MPP組血清IFN-γ、IL-1β水平及IFN-γ/IL-4比值高于非MPP組(P＜0.01)；MPP組恢複期TNF-α、IL-1β、IL-6水平和IFN-γ/IL-4比值較急性期明顯降低(P ＜0.001,P＜0.05)；重癥MPP組血清TNF-a、IL-1β水平及IFN-γ、IL-4比值明顯高于輕癥MPP組(P＜0.01).結論 MPP患兒存在免疫功能紊亂,血清中TNF-α、IL-1β、IL-6水平及IFN-γ/IL-4比值與病情嚴重程度相關,可用來評估病情.
목적 탐토폐염지원체폐염(mycoplasma pneumoniae pneumonia,MPP)환인혈청세포인자수평적변화급림상의의.방법 선택2008년1월지2009년12월아원인내과수치적MPP환인239례위MPP조,근거병정적엄중정도재분위경증MPP조(n=152)화중증MPP조(n=87).선택동기수치적급성지기관폐염환인263례위비MPP조.선택동기재인외과주원적산기화포피과장택기수술환인공50례작위대조조.소유폐염환인균우입원제1천진행폐염지원체항체검측화세포인자[종류배사인자(TNF)-α、γ간우소(IFN-γ)、백세포개소(IL)-1β、IL-4、IL-6]검측,환인경치료감염회복기중신류취혈청복사이상지표；대조조류취1차혈청,검측세포인자수평.결과 MPP조화비MPP조환인혈청TNF-α、IL-1β、IL-6수평균고우대조조(P＜0.01)；이IFN-γ、IL-4수평3조간비교차이무통계학의의(P ＞0.05)；MPP조혈청IFN-γ、IL-1β수평급IFN-γ/IL-4비치고우비MPP조(P＜0.01)；MPP조회복기TNF-α、IL-1β、IL-6수평화IFN-γ/IL-4비치교급성기명현강저(P ＜0.001,P＜0.05)；중증MPP조혈청TNF-a、IL-1β수평급IFN-γ、IL-4비치명현고우경증MPP조(P＜0.01).결론 MPP환인존재면역공능문란,혈청중TNF-α、IL-1β、IL-6수평급IFN-γ/IL-4비치여병정엄중정도상관,가용래평고병정.
Objective To investigate the changes of serum cytokines in children with mycoplasma pneumoniae pneumonia (MPP).Methods A total of 239 children with MPP hospitalized in our department from Jan 2008 to Dec 2009 served as MPP group,which were redivided into mild MPP group (n =152) and severe MPP group ( n =87 ).Two hundred and sixty-three acute bronchopneumonia children without MPP infection served as non-MPP group.Fifty cases who would undergo hernia and phimosis elective surgery in pediatric surgery department served as control group.All children with pneumonia were detected mycoplasma pneumoniae antibodies and cytokines (TNF-α,IFN-γ,IL-1β,IL-4,IL-6) of serum in the first day of hospitalization and recovery period.Children in control group were detected the level of cytokines only once.Results Serum levels of TNF-α,IL-1β,IL-6 in MPP group and non-MPP group were higher than those in control group ( P ＜ 0.01 ).No significant differences of IFN-γ and IL-4 levels were found among three groups ( P ＞ 0.05 ).Compared with non-MPP group,the levels of IFN-γ,IL-1β and IFN-γ/IL-4 were higher in MPP group ( P ＜ 0.01 ).The levels of TNF-α,IL- 1β,IL-6,and IFN-γ/IL-4 were significantly decreased in the recovery period of MPP (P ＜0.001,P ＜ 0.05 ).The levels of TNF-α,IL-1β and IFN-γ/IL-4 in severe MPP children were higher than those in mild MPP children ( P ＜ 0.01 ).Conclusion The immunologic function of MPP children is unbalanced.The serum levels of TNF-α,IL-1β,IL-6,and IFN-γ/IL-4 are correlated with severity of MPP,which help to evaluate the state of MPP.
