儿童肺炎支原体肺炎血清sB7-H3及相关细胞因子的水平变化及临床意义

摘要

目的 通过分析肺炎支原体肺炎(MPP)患儿血清中可溶性B7-H3(sB7-H3)及相关细胞因子的表达水平,探讨血清sB7-H3与相关细胞因子的相关性,并评价其在MPP发生发展过程中所起的作用.方法 选取2016年1月～2017年1月在河北医科大学第四医院儿科住院治疗的1 10例MPP患儿(MPP组),根据患儿病情分为重症MPP组(54例),轻症MPP组(56例).另外选择同期健康体检儿童作为正常对照组(38例).通过全自动酶标仪检测MPP患儿血清中sB7-H3及干扰素-γ(IFN-γ)、粒细胞巨噬细胞刺激因子(GM-CSF)、白介素-4(IL-4)、白介素-17(IL-17)的表达水平.结果 MPP组急性期患儿血清sB7-H3、IFN-γ、GM-CSF、IL-17水平明显高于本组恢复期及对照组,MPP组急性期IL-4的表达水平低于本组恢复期及对照组(P＜0.05).MPP组恢复期血清中各因子水平明显高于对照组,IL-4水平低于对照组(P＜0.05).MPP组重症期患儿血清sB7-H3、IFN-γ、GM-CSF、IL-17水平明显高于轻症MPP组(P＜0.05),两组之间IL-4水平差异无统计学意义(P＞0.05).MPP患儿急性期血清中sB7-H3分别与IFN-γ、GM-CSF呈正相关(r=0.573、0.682,均P＜0.01),而与IL-4、IL-17水平无显著相关性(P＞0.05).结论 sB7-H3及细胞因子IFN-γ、GM-CSF、IL-4、IL-17在MPP患儿感染中起着重要的作用,参与了MPP的发病过程,其水平高低与病情严重程度有关.%Objective To explore the relationship between serum sB7-H3 and related cytokines,and to evaluate its process in the development of Mycoplasma Pneumoniae pneumonia (MPP) through the analysis of the expression of serum soluble B7-H3 (sB7-H3) and related cytokines in MPP.Methods 110 cases children with MPP in the Fourth Hospital of Hebei Medical University from January 2016 to January 2017 were selected as the MPP group and divided into severe MPP group (54 cases),mild MPP group (56 cases) according to the condition of children.In addition,healthy children were selected as the normal control group (38 cases).The levels of sB7-H3,IFN-γ,GM-CSF,IL-4 and IL-17 in serum of MPP were detected by automatic microplate reader.Results The levels of sB7-H3,IFN-γ,GM-CSF and IL-17 in the serum of MPP children was significantly higher than those in the recovery phase and the control group (P ＜ 0.05).The expression level of IL-4 in acute phase was lower than that in recovery phase and control group (P ＜ 0.05).The levels of serum in the recovery phase of the MMP group was significantly higher than those in the control group (P ＜ 0.05).IL-4 levels was lower than those in the control group.The levels of sB7-H3,IFN-γ,GM-CSF and IL-17 in the serum of MPP group were significantly higher than those of mild MPP (P ＜ 0.05).There was no statistical difference in IL-4 levels between the two groups (P ＞ 0.05).Serum level of sB7-H3 was positively correlated with IFN-and GM-CSF in acute phase of MPP (r =0.573,0.682,all P ＜ 0.01),but not significantly related to the levels of IL-4 and IL-17 (P ＞ 0.05).Conclusion sB7-H3 and cytokines IFN-γ,GM-CSF,IL-4 and IL-17 play an important role in the infection of children with MPP and participate in the pathogenesis of MPP.The levels of them is related to the severity of the disease.