难治性肺炎支原体肺炎患儿支气管肺泡灌洗液中IL-4、IL-6、IFN-γ的水平及支气管镜下特点

摘要

Objective To explore the interleukin-4 (IL-4),interleukin-6 (IL-6),interferon-gamma (IFN-γ) levels in bronchoalveolar lavage fluid (BALF) of children with refractory mycoplasma pneumoniae pneumonia,and the features of bronchoscopy.Methods A total of 47 children with refractory mycoplasma pneumoniae pneumonia were selected as the observation group,28 children with bronchial foreign body in GAN zhengyan were chosen as controls during the same period.ELISA method was used to detect the IL-4,IL-6,IFN-γ levels in the BALF,and compared them in these two groups.The bronchoscope features of the observation group were observed.Results The IL-4,IL-6,IFN-γ levels in the BALF of children in the observation group were (8.3 ± 3.1) pg/mL,(62.3 ± 18.4) pg/mL,(76.5 ± 21.9) pg/mL,and they were significantly higher than those of the controls (3.1 ± 1.2) pg/m L,(30.0 ± 1.5) pg/m L,(31.3 ± 24.9) pg/mL (P ＜0.05,respectively).In the observation group,the bronchial mucosa congestion and edema were observed in all patients,there were variable amounts of mucus secretions.There were other changes include:microtubule reductus (68.1％),bronchial mucosal follicle-like hyperplasia (38.3％),mucosal erosions (8.5％),airway inflammatory stenosis,mucus plug blocking (59.6％),granulation proliferation (14.9％),bronchial obliteration (4.3％) Conclusions The IL-4,IL-6,IFN-γ levels in the BALF of children with RMPP significantly increased.This indicates a significant local inflammatory response in children with RMPP.Mycoplasma pneumoniae pneumonia (MPP) has certain features of bronchoscope,these features are helpful to the diagnosis and treatment of MPP.%目的 探讨肺泡灌洗液(BALF)中白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、干扰素(IFN-γ)水平的变化及难治性肺炎支原体肺炎(RMPP)患儿支气管镜下特点.方法 选择RMPP患儿47例为观察组,以同期就诊于昆明医科大学附属儿童医院的支气管异物患儿28例作为对照组,采用ELISA法检测并比较2组患儿BALF中IL-4、IL-6、IFN-γ的水平;观察观察组的支气管镜下特点.结果 观察组患儿BALF中IL-4、IL-6、IFN-γ水平分别为(8.3±3.1) pg/mL、(62.3±18.4) pg/mL、(76.5± 21.9) pg/mL,明显高于对照组的(3.1±1.2) pg/mL、(30.0±1.5) pg/mL、(31.3± 24.9) pg/mL,2组比较差异有统计学意义(P＜0.05).观察组所有患儿均可见病变部位的支气管黏膜充血水肿,可见数量不等的黏稠分泌物附着,其他改变包括:管壁纵行皱褶(68.1％),黏膜滤泡样增生(38.3％),黏膜糜烂(8.5％),支气管炎性狭窄(40.4％),管腔内黏液栓堵塞(59.6％),管腔内肉芽组织增生(14.9％),管腔闭塞(4.3％).结论 RMPP患儿BALF中IL-4、IL-6、IFN-γ水平明显升高,提示RMPP患儿病变局部炎症反应明显.支原体肺炎(MPP)有一定的支气管镜下特点,这些特点有助于MPP的诊治.