儿童肺炎链球菌合并支原体感染的体液免疫功能状态分析

摘要

Objective Analysising the level of body fluids in children with pneumococcal complicated with mycoplasma pneumonia infection and exploring the pathogenesis of mixed infection with two pathogens,to guide clinical treatment. Methods 944 cases of pneumonia in children were detected sputum,bronchoalveolar lavage fluid specimens of MP-DNA by type BIORAD-C1000 fluorescence PCR,serum IgG,IgM,IgA,C3, C4 content by de Ling-BN2,exclusion of respiratory syncytial virus,respiratory adenovirus,influenza virus,influenza virus,parainfluenza virus, EB virus,chlamydia,Q Rickettsia,and Legionella pneumophila antibody positive cases. Results The levels of IgG,IgM,C3,C4 in children with pneumococcal complicated with mycoplasma pneumonia infection were higher than the normal control group(P<0.05);no significant gender differences in humoral immunity(P>0.05).Comparison of fluid levels in different age groups:IgG,IgA,IgM levels were significantly different in different age groups in normal children(P<0.05),while C3 C4 had no significant difference;The leves of IgG,IgA,IgM,C3 of SP+MP group had statistically significant differences in different age groups(P<0.05).C4 had no statistically significant difference in different age groups (P>0.05).SP+MP group(1-3 years old) IgG,IgA,IgM,C3 higher than the normal control group(P<0.05),3-6 years old children,the levels of IgG,IgA,IgM,C3,SP+MP infection was higher than the normal control group(P<0.05),>6 years old children with C3,C4 after SP+MP infection was higher than that of the normal control group(P<0.05).The leves of IgA,IgM,C3 in SP+MP,SP,MP infection showed a rising trend. Conclusion The pathogenesis of MP and SP is different,the corresponding humoral immune performance is not the same,for children with SP,MP infection should be based on the age and the age group of the normal level of comparative analysis to draw the correct conclusion.%目的 分析肺炎链球菌合并支原体感染患儿的体液水平,探讨2种病原体混合感染的致病机制,指导临床治疗.方法 944例肺炎患儿采用BIORAD-C1000型荧光PCR仪检测痰液、肺泡灌洗液标本中的MP-DNA,德灵-BN2检测血清IgG、IgA、IgM、C3、C4含量,排除呼吸道合胞病毒、呼吸道腺病毒、甲型流感病毒、乙型流感病毒、副流感病毒、EB病毒、衣原体、Q热立克次体、及嗜肺军团菌等抗体阳性病例.结果 肺炎链球菌合并支原体感染患儿IgG、IgM、C3、C4均高于正常对照组(P<0.05);体液免疫的性别差异无统计学意义(P>0.05);不同年龄组间体液水平的组间比较:正常对照儿童的IgG、IgA、IgM水平在不同的年龄组间差异有统计学意义(P<0.05),而C3、C4在不同年龄组差异无统计学意义;SP+MP感染组IgG、IgA、IgM、C3各年龄组间差异有统计学意义(P<0.05),C4不同年龄组间差异无统计学意义(P>0.05),1~3岁患儿SP+MP组IgG、IgA、IgM、C3比正常对照组升高(P<0.05),3~6岁患儿IgG、IgA、IgM、C3水平SP+MP感染比正常对照组升高(P<0.05),>6岁患儿C3、C4在SP+MP感染后高于正常对照组(P<0.05).IgA、IgM、C3在SP+MP、SP、MP感染后均呈现一直上升的趋势.结论 MP和SP的致病机制不同,相应的体液免疫表现也不相同,对于儿童SP、MP感染应根据年龄结合同年龄组正常水平比较分析才能得出正确结论.