CAJ | 학술논문

目的探讨血清肺表面活性蛋白D(SP-D)、甘露聚糖结合凝集素(MBL)在婴儿巨细胞病毒(CMV)肺炎中的变化及临床意义.方法收集2011年1月至2012年12月临床诊断为CMV肺炎住院患儿101例,男女比例1:1.1,平均年龄(2.69±1.02)个月;按肺部体征与肺外并发症严重程度,将其分为重症肺炎组(48例)和轻症肺炎组(53例);选择同期住院的非感染性疾病患儿作为对照组(55例).采用酶联免疫法测定各组患儿血清SP-D、MBL水平,并对重症肺炎患儿行血气分析检测动脉血氧分压(PaO2).结果重症肺炎组[(150.08 ±52.59) ng/ml]和轻症肺炎组[(109.67 ±31.39) ng/ml]血清SP-D水平较对照组[(41.33±16.42) ng/ml]均明显升高(P＜0.01),且重症肺炎组SP-D水平高于轻症肺炎组(P＜0.01);三组间血清MBL水平差异无统计学意义(P＞0.05);重症肺炎患儿血清SP-D水平与PaO2呈显著负相关(r=-0.565,P＜0.01).结论血清SP-D水平与婴儿CMV肺炎的严重程度密切相关,而MBL水平与其无关.检测婴儿CMV肺炎血清SP-D水平,对病情严重程度的判断具有重要的临床指导意义.
목적 탐토혈청폐표면활성단백D(SP-D)、감로취당결합응집소(MBL)재영인거세포병독(CMV)폐염중적변화급림상의의.방법 수집2011년1월지2012년12월림상진단위CMV폐염주원환인101례,남녀비례1:1.1,평균년령(2.69±1.02)개월;안폐부체정여폐외병발증엄중정도,장기분위중증폐염조(48례)화경증폐염조(53례);선택동기주원적비감염성질병환인작위대조조(55례).채용매련면역법측정각조환인혈청SP-D、MBL수평,병대중증폐염환인행혈기분석검측동맥혈양분압(PaO2).결과 중증폐염조[(150.08 ±52.59) ng/ml]화경증폐염조[(109.67 ±31.39) ng/ml]혈청SP-D수평교대조조[(41.33±16.42) ng/ml]균명현승고(P＜0.01),차중증폐염조SP-D수평고우경증폐염조(P＜0.01);삼조간혈청MBL수평차이무통계학의의(P＞0.05);중증폐염환인혈청SP-D수평여PaO2정현저부상관(r=-0.565,P＜0.01).결론 혈청SP-D수평여영인CMV폐염적엄중정도밀절상관,이MBL수평여기무관.검측영인CMV폐염혈청SP-D수평,대병정엄중정도적판단구유중요적림상지도의의.
Objective To investigate the levels of serum surfactant protein D (SP-D) and mannosebinding lectin (MBL) in infants with cytomegalovirus (CMV) pneumonia with the severity of disease.Methods A total of 101 hospitalized infants with CMV pneumonia were enrolled from January 2011 to December 2012.These patients were divided as the severe pneumonia group (n =48) and the mild pneumonia group (n =53) according to physical sign of lung and complication.Another 55 infants who were hospitalized in the same period with non-infectious diseases were used as the control group.Serum levels of SP-D and MBL were detected by enzyme-linked immunosorbent assay.Blood gas analyzer was used to measure arterial partial pressure of oxygen (PaO2) of the blood in severe patients.Results The mean serum SP-D levels in the severe pneumonia group [(150.08 ±52.59)ng/ml] and the mild pneumonia group [(109.67 ±31.39)ng/ml] were significantly higher than those in control group [(41.33 ± 16.42) ng/ml] (P ＜ 0.01), and higher in the severe pneumonia group than in the mild pneumonia group (P ＜ 0.01).However, there was no significant difference in serum MBL between all groups (P ＞ 0.05).In severe patients, serum SP-D levels were negatively correlated with PaO2 (r =-0.565, P ＜ 0.01).Conclusion Serum SP-D is associated with the severity of CMV pneumonia, but MBL shows no relation.The serum SP-D levels has an important clinical significance in judgment the sererity of infants with CMV pneumonia.