细胞因子谱、C-反应蛋白及降钙素原在小儿重症支原体肺炎诊治中的临床意义

摘要

目的 探讨小儿肺炎急性期血清细胞因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、降钙素原(PCT)的浓度水平变化在小儿重症支原体肺炎诊治中临床意义.方法 选取肺炎患儿127例,将其中64例支原体肺炎(MPP)作为研究组,63例非支原体肺炎(NMPP)患儿作为对照组;并将研究组分为重症组和轻症组,同时又可将重症组MPP分为急性期和恢复期.采用酶联免疫吸附实验法(ELISA)检测各组急性期血清CRP、PCT、IL-1β、IL-6、IL-8、IL-10、TNF-α的浓度变化及重症MPP组恢复期各炎症指标浓度水平.结果 研究组和对照组患儿血清IL-1β浓度水平变化无统计学意义(P>0.05).重症组患儿急性期血清IL-6、IL-8、TNF-α、CRP、PCT的浓度水平均高于轻症组、对照组和重症组恢复期比较,均差异有统计学意义(P<0.05),而血清IL-10在重症组、轻症组和对照组的浓度水平比较,差异无统计学意义(P>0.05).ROC曲线分析血清IL-6检测在诊断MPP上特异性较高.结论 血清IL-6、IL-8、TNF-α、CRP、PCT等炎症指标对早期诊治重症MPP有重要意义.%Objective To explore the clinical significance in diagnosis of severe children mycoplasma pneumoniae pneumonia,detecting the serum changing levels of cytokine profiles,c-reactive protein (CRP)and procalcitonin(PCT) in the acute phase.Methods 127 cases of pneumonia were randomly selected to study.64 cases were served as the research group (MPP) and divided to the severe and mild group.63 cases were served as the control group(NMPP),which was also divided into the acute and recovery phase.ELISA was used to observe the levels of serum interleukin-1β (IL-1β),interleukin-6 (IL-6),interleukin-8 (IL-8),interleukin-10 (IL-10),tumor necrosis factorα (TNF-α),PCT,CRP in the acute phase of the research group,control group and in the recovery phase of the severe group.Results IL-1βshowed no significant difference between the research group and the control group (P>0.05);Serum concentrations of IL-6,IL-8,TNF-α,CRP,PCT of the severe group in acute phase were higher than the mild group,control group and the recovery phase of its.The differences between the three groups were statistically significant(P<0.05).The levelsof serum interleukin-10 hadnodifferences in the three groups.There was no statistically significant difference comparison (P>0.05).ROC curve analysis showed that serum IL-6 had higher specificity in diagnosis of MPP.Conclusion Detecting the serum levels of IL-6,IL-8,TNF-α,CRP,PCT had important clinical significancein early diagnosis of severe children mycoplasma pneumoniae pneumonia.