支原体肺炎患儿血清炎性细胞因子、免疫球蛋白、补体、hs-CRP水平变化及意义

摘要

目的 观察支原体肺炎(MPP)患儿血清炎性细胞因子(IL-2、IL-6)、免疫球蛋白(Ig)和补体、高敏C-反应蛋白(hs-CRP)水平的变化,并探讨其意义.方法 MPP患儿50例(观察组,其中重症28例、轻症22例),健康儿童42例作为对照组.采用ELISA法检测两组血清IL-2、IL-6,用血浆蛋白分析仪速率散射比浊法检测hs-CRP、Ig和补体(C3、C4)水平.结果 与对照组比较,观察组急性期IL-2、IgA水平降低,IL-6、hs-CRP、IgM 、IgG、C3、C4水平升高(P ＜0.05或0.01)；恢复期IL-2水平降低,hs-CRP、IgG水平升高(P＜0.05或0.01).与恢复期比较,观察组急性期IL-2水平降低,IL-6、hs-CRP、C3水平升高(P＜0.01).与轻症者比较,重症者IL-2、IgA水平降低,IL-6、hs-CRP、IgM、IgG、C3、C4水平升高(P＜0.05或＜0.01).MPP患儿血清中IL-2与IL-6呈负相关(r=-0.634,P=0.017).结论 MMP急性期、恢复期或重症、轻症患儿血清炎性细胞因子、Ig、补体、hs-CRP水平升高或降低,联合检测上述指标可及时判定MMP病情程度和预后,有助于指导MP患儿的治疗.%Objective To observe the changes of serum cytokine(IL-2 and IL-6) , imunoglobulin (Ig) , complement, high-sensitivity C-reactive protein (hs-CRP) in children with mycoplasma pneumonia (MPP)and to probe into the clinical significance. Methods 50 children with MPP (the observed group, of whom 28 were severe cases and 22 were mild cases) and 42 healthy children (the matched group)were enrolled, ELISA was used to determine the ordinary pneumonia serum IL-2, IL-6 levels, scattering rate turbidime-tric method was used to determine the contents and composition of hs-CRP, Ig and complement (C3, C4). Results Compared with matched group, during the severe period, IL-2 and IgA levels in the observed group decreased, levels of IL-6, hs-CRP, IgM , IgG, C3 , C4 increased(P <0. 05 or 0.01) ; whereas during convalescence period, IL-2 level decreased, levels of hs-CRP, IgG increased(P <0. 05 or 0.01). Compared with convalescence, IL-2 level in the observed group decreased, levels of IL-6, hs-CRP, C3 increased(P <0. 01). Compared with mild cases, levels of IL-2, IgA in severe cases decreased, levels of IL-6, hs-CRP, IgM, IgG, C3, C4 increased (P< 0.05 or <0.01). IL-6 concentration was negatively correlated with the IL-2 level in MPP patients( r = -0.634, P=0.017). Conclusions Serum cytokine, Ig, complement, hs-CRP in children with MPP decrease or increase during severe and convalescence period or in severe and mild cases; The detection of these indexes will facilitate determining the state of illness and prognosis and help guide the therapy of MPP.