肺炎支原体肺炎患儿转氨酶水平及其影响因素

摘要

Objective To compare the levels of aminotransferases between children with Mycoplasma pneumoniae pneumonia (MPP) and those of non-MPP, and to explore the factors influencing the levels of aminotransferases in children with MPP. Methods Lievr enzymes of aminotransferases were detected in 99 children of MPP (MPP), 120 of non-MPP (non-MPP group) and 63 healthy children (the control group). The relationship of glutamic-pyruvic transaminase (ALT) levels with age, course of disease, degree and duration of fever, WBC count and C-reactive protein (CRP) of peripheral blood and MP-IgM titer was investigated. Results The abnormal rate of ALT, glutamic-oxalacetic transaminease (AST) and gamma-gluiamyltransferase (γ-GT) in MPP group was 5.05%, 37.37% and 3.03%, respectively. There was no statistically significant differences in abnormal rate and the levels of ALT and AST between MPP group and non-MPP group, but γ-GT levels of MPP group were significantly higher than that of non-MPP group (P<0.05). ALT levels of MPP group showed significant positive relationship with CRP and MP-IgM titer (P<0.05), but nosignificant relationship with age, course of disease, degree and duration of fever, WBC count of peripheral blood. Conclusion Liver function impairment is not common in children with MPP, but γ-GT levels of children with MPP are significantly higher than those of non-MPP. There were significant positive relationship between ALT levels of MPP group and CRP, MP-IgM titer. Immune injury might be one of the main mechanisms of MP-induced liver function impairment.%目的 比较肺炎支原体肺炎(MPP)和非MPP患儿转氨酶水平,并探讨MPP患儿转氨酶水平的影响因素.方法 分别检测99 例MPP患儿、120 例非MPP患儿和63 例健康儿童的肌酶水平,并对MPP患儿谷丙转氨酶(ALT)水平与患儿年龄、病程、发热程度及时间、血常规WBC计数、外周血C-反应蛋白(CRP)水平及肺炎支原体(MP) IgM滴度进行相关分析.结果 MPP组患儿ALT、谷草转氨酶(AST)及γ-谷氨酰转移酶(γ-GT)的异常率分别为5.05%、37.37%和3.03%,其异常率及ALT、AST水平与非MPP组比较差异无统计学意义,但γ-GT水平显著高于非MPP组患儿(P<0.05),且MPP组患儿ALT水平与外周血CRP水平和MP-IgM 滴度呈显著正相关(P<0.05),与患儿年龄、发热程度及时间、外周血WBC计数无显著相关.结论 小儿MPP致肝功能损害并不常见,但MPP组患儿γ-GT水平显著高于非MPP组,且MPP组ALT 水平与外周血CRP 水平和MP-IgM 滴度呈显著正相关,提示免疫损伤可能是小儿MPP致肝功能损害的主要机制之一.