探讨肺炎支原体感染与儿童喘息发作的关系及机制

摘要

目的：比较肺炎支原体肺炎（MPP）、非肺炎支原体肺炎（非MPP）与健康儿童的免疫功能，以探讨肺炎支原体感染对儿童喘息发作的影响机制。方法分别检测和比较279例肺炎支原体肺炎患儿、318例非肺炎支原体肺炎和50例健康儿童的体液免疫和T淋巴细胞亚群的表达水平，并比较肺炎支原体肺炎与非肺炎支原体肺炎患儿咳嗽、发热、喘息等临床症状出现的比例。结果肺炎支原体肺炎患儿咳嗽发热的发生率与非肺炎支原体肺炎差异无统计学意义。肺炎支原体肺炎患儿的喘息发生率明显高于非肺炎支原体肺炎。体液免疫方面，肺炎支原体肺炎组血清IgA、IgM、IgE明显高于非肺炎支原体肺炎组和健康儿童组（P<0.05）。T淋巴细胞亚群的表达水平方面，肺炎支原体肺炎组的CD3+、CD4+、CD4+/CD8+值明显少于非肺炎支原体肺炎组和健康儿童组（P<0.05），肺炎支原体肺炎组CD8+值明显高于非肺炎支原体肺炎组和健康儿童组（P<0.01）。结论与非肺炎支原体肺炎和健康儿童比较，肺炎支原体肺炎患儿存在明显体液免疫和T淋巴细胞亚群的表达水平异常，更易诱发喘息。%ObjectiveTo determine the relationship between MP infection and immunoglobulins,and to clarify the associated mechanisms of inflammatory response.MethodsA prospective study was performed among 279 children with MPP,318 children with non-MPP and 50 healthy children. The levels of serum immunoglobutins(IgG,IgA,IgM and IgE)and T cell subgroup(CD3+,CD4+,CD8,CD4/CD8)were detected. Results Serum IgA,IgM and IgE levels for MPP patients were obviously higher than those in the other groups(P<0.01). The proportion of CD3+, CD4+ T cells and the ratio of CD4/CD8 for MPP patients were significantly lower than those in the other group(P<0.01). The proportion of CD8+T cells for MPP patients were obviously higher than those in the other groups(P<0.01).ConclusionsImmune function disturbance may exist in children with MPP. An infection with MP may precede the onset of wheeze.