摘要
目的探讨肺炎支原体感染不同病期婴幼儿免疫功能及炎症因子水平的动态变化。方法选取深圳市龙华区中心医院2016年4月至2018年4月收治的80例肺炎支原体感染不同病期婴幼儿作为观察对象,其中急性期组和恢复期组各40例,选取同期体检的40例健康儿童作为对照组。分别对各组婴幼儿的免疫球蛋白及补体、外周血T淋巴细胞亚群及细胞炎症因子水平进行比较。结果各组患儿免疫球蛋白(IgG、IgM和IgA)及补体(C3和C4)水平差异具有统计学意义(F=5.902、2.936、3.187、2.059、3.786,P=0.000、0.011、0.008、0.021、0.004),其中恢复期组患儿IgG水平为(10.30±2.27)g/L,显著高于急性期组和对照组(t=3.203、3.044,P均<0.001),急性期组患儿IgM、C3、C4显著高于对照组和恢复期组(P均<0.05),急性期组与恢复期组患儿IgA水平显著低于对照组(t=2.565、P=0.021,t=2.752、P=0.018)。各组患儿T淋巴细胞亚群(CD3~+、CD4~+、CD8~+、CD4/CD8)、NK细胞差异均具有统计学意义(F=8.602、9.031、8.917、4.281、4.335,P均<0.001),其中急性期组和恢复期组患儿CD3~+、CD4~+、CD4/CD8和NK细胞水平均显著低于对照组(P均<0.05),急性期组和恢复期组患儿CD8~+T分别为(35.53±5.33)%和(30.47±4.17)%,显著高于对照组(27.81±4.51)%(t=3.742、P <0.001,t=2.184、P=0.028),且急性期组患儿CD8~+、CD4/CD8、NK细胞与恢复期组差异具有统计学意义(t=2.770、2.337、2.182,P=0.020、0.023、0.024)。各组患儿细胞炎症因子(hBD-1、hBD-2、TNF-α、IL-8、IL-10和IL-13)水平差异具有统计学意义(P均<0.001),其中急性期组与恢复期组患儿TNF-α、IL-8、IL-10和IL-13显著高于对照组(P均<0.05),而hBD-1显著低于对照组(t=3.583、P <0.001,t=3.192、P=0.001),急性期组患儿TNF-α、IL-8、IL-10和IL-13显著高于恢复期组(P均<0.05)。结论肺炎支原体感染病患儿存在免疫功能缺陷和炎症因子水平异常,临床诊疗中应予以重视。
Objective To investigate the dynamic changes of immune function and inflammatory factors in infants with mycoplasma pneumonia infection. Methods From April 2016 to April 2018, a total of80 infants with mycoplasma pneumonia infection were selected as observation subjects, including 40 cases in acute stage group and 40 cases in convalescence stage group, while 40 healthy children were selected as control group. Results There were significant differences in levels of immunoglobulin(IgG, IgM and IgA)and complement(C3 and C4) among the groups(F = 5.902, 2.936, 3.187, 2.059, 3.786; P = 0.000, 0.011,0.008, 0.021, 0.004). The level of IgG in convalescent group was(10.30 ± 2.27) g/L, which was significantly higher than that of acute phase group and control group(t = 3.203, 3.044; both P < 0.001). Levels of IgM,C3 and C4 were significantly higher than those of control group and convalescence group(all P < 0.05).IgA level in acute phase group and convalescence group were significantly lower than that of control group(t = 2.565, P = 0.021; t = 2.752, P = 0.018). The difference of T lymphocyte subsets(CD3, CD4, CD8, CD4/CD8) and NK cells were statistically significant in each group(F = 8.602, 9.031, 8.917, 4.281, 4.335; all P <0.001), the levels of CD3, CD4, CD4/CD8 and NK cells of acute phase group and convalescence group were significantly lower than those of control group(all P < 0.05). Levels of CD8+ T of acute phase group and convalescence group were(35.53 ± 5.33)% and(30.47 ± 4.17)%, respectively, which were significantly higher than those of control group [(27.81 ± 4.51)%](t = 3.742, P < 0.001; t = 2.184, P = 0.028), and the difference of CD8, CD4/CD8, NK cells in acute phase group and convalescent group were significantly different(t =2.770, 2.337, 2.182; P = 0.020, 0.023, 0.024). The levels of cytokines(hBD-1, hBD-2, TNF-α, IL-8, IL-10 and IL-13) were significantly different in each group(all P < 0.001), the levels of TNF-α, IL-8, IL-10 and IL-13 in acute phase group and convalescence group were significantly higher than those of control group(all P <0.001), but level of HBD-1 was significantly lower than that of the control group(t = 3.583, P < 0.001; t =3.192, P = 0.001); the levels of TNF-α, IL-8, IL-10 and IL-13 in acute phase group were significantly higher than those of convalescence group(all P < 0.05). Conclusions The children with mycoplasma pneumonia infection have the deficiency of immune function and abnormal level of inflammatory factors, which should be paid more attention in clinical diagnosis and treatment.
引文
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