张佳夫 李艳玲

【摘要】 目的：探究炎性細胞因子与体液免疫动态检测对小儿支原体肺炎的病情评估作用。方法：选取2019年1-12月本院收治的46例小儿支原体肺炎患者设为A组，其中，轻型24例，重型22例，另选取同期在本院体检的45例健康儿童设为B组。采用酶联免疫吸附法（ELISA）检测并比较两组炎性细胞因子。采用免疫散射比浊法测定并比较两组血清补体及免疫球蛋白。结果：A组治疗3、7、15 d的C3与C4水平均低于治疗前，且IgM、IgG、IgA水平均高于治疗前（P<0.05）。治疗3、7 d，A组C3均高于B组，且IgM、IgG、IgA水平均低于B组（P<0.05），而A组C4与B组比较，差异均无统计学意义（P>0.05）。治疗15 d，A组的C3、C4、IgM、IgG、IgA水平与B组比较，差异均无统计学意义（P>0.05）。治疗前和治疗3、7 d，A组IL-8、IL-10、IL-13、TNF-α水平均高于B组（P<0.05）。A组治疗3、7、15 d的IL-8、IL-10、IL-13、TNF-α水平均低于治疗前（P<0.05）。治疗15 d，A组IL-8、IL-10、IL-13、TNF-α水平与B组比较，差异均无统计学意义（P>0.05）。重型患儿IgM、IgG及IgA水平均低于轻型患儿及B组，C3与C4水平均高于轻型患儿（P<0.05）。重型患儿的TNF-α、IL-8、IL-10及IL-13水平均高于轻型患儿及B组，且轻型患儿均高于B组（P<0.05）。结论：在小儿支原体肺炎中，患儿存在体液和细胞免疫功能紊乱，展开炎性细胞因子与体液免疫动态检测，可对患儿的疾病严重程度进行合理评估。

【关键词】 小儿支原体肺炎 炎性细胞因子 体液免疫 动态检测

Dynamic Detection of Inflammatory Cytokines and Humoral Immunity in the Evaluation of Mycoplasma Pneumonia in Children/ZHANG Jiafu， LI Yanling. //Medical Innovation of China， 2021， 18（05）： 0-020

[Abstract] Objective： To explore the effect of dynamic detection of inflammatory cytokines and humoral immunity on the evaluation of mycoplasma pneumonia in children. Method： A total of 46 children with mycoplasma pneumonia admitted to our hospital from January to December 2019 were selected as group A， including 24 mild cases and 22 severe cases. And 45 healthy children underwent physical examination in our hospital during the same period were selected as group B. The inflammatory cytokines were detected and compared between the two groups by enzyme-linked immunosorbent assay （ELISA）. Serum complement and immunoglobulin were detected and compared between the two groups by immunoturbidimetry. Result： The levels of C3 and C4 in group A at treatment for 3， 7 and 15 d were lower than those before treatment， the levels of IgM， IgG and IgA in group A were higher than those before treatment （P<0.05）. At treatment for 3， 7 d， the levels of C3 in group A were higher than those in group B， and the levels of IgM， IgG and IgA in group A were lower than those in group B （P<0.05）， while there was no statistically significant difference in C4 between group A and group B （P>0.05）. At treatment for 15 d， there were no statistically significant differences in the levels of C3， C4， IgM， IgG and IgA between group A and group B （P>0.05）. The levels of IL-8， IL-10， IL-13 and TNF-α in group A were higher than those in group B before treatment， at 3 and 7 d for treatment （P<0.05）. The levels of IL-8， IL-10， IL-13 and TNF-α in group A at 3， 7 and 15 d for treatment were lower than those before treatment （P<0.05）. At 15 d for treatment， there were no significant differences in the levels of IL-8， IL-10， IL-13 and TNF-α between group A and group B （P>0.05）. The levels of IgM， IgG and IgA in severe children were lower than those in mild children and group B， and the levels of C3 and C4 were higher than those in mild children （P<0.05）. The levels of TNF-α， IL-8， IL-10 and IL-13 in severe children were higher than those in mild children and group B， and those in mild children were higher than those in group B （P<0.05）. Conclusion： In children with mycoplasma pneumoniae， there are humoral and cellular immune disorders in children， dynamic detection of inflammatory cytokines and humoral immunity can reasonably evaluate the severity of the disease in children.

[Key words] Mycoplasma pneumonia in children Inflammatory cytokines Humoral immunity Dynamic detection

First-authors address： Jiamusi Maternal and Child Health Hospital， Jiamusi 154004， China

doi：10.3969/j.issn.1674-4985.2021.05.005

小儿支原体肺炎是肺炎支原体感染后，引起的小儿支气管和肺泡急性炎症，临床主要表现为咳嗽、发热、乏力、头痛等症状，具有传染性，其病原体可通过患儿口、鼻等经飞沫和接触传播[1-3]。临床多通过查体、X线、血清学检查、肺炎支原体核酸检测等方式对疾病展开诊断，治疗方面则在隔离、供氧、降温等基础上，采用以药物治疗为主的干预方案，多数患儿预后良好[4]。但是，在肺炎支原体感染后致病机制不确定的情况下，增加了多种并发症发生的可能性。有研究指出，肺炎支原体与小儿患者的免疫功能紊乱、炎症损伤、呼吸道上皮吸附作用等存在密切关系[5-6]。考虑到炎性反应和免疫损伤在小儿支原体肺炎进展中的作用，本次研究选取本院46例小儿支原体肺炎患儿，探究炎性细胞因子与体液免疫动态检测对患儿病情的评估作用，现报道如下。