难治性肺炎支原体肺炎感染患儿免疫功能状态分析.docVIP

难治性肺炎支原体肺炎感染患儿免疫功能状态分析 　　[摘要]目的 探讨小儿难治性支原体肺炎对免疫功能状态的影响。方法 选取2014年2月～2016年11月在我院治疗的100例难治性支原体肺炎患儿，作为实验组；另选100例普通支原体肺炎患儿，作为对照组。采用流式细胞仪和免疫透射比浊法检测并比较两组患儿血清免疫球蛋白、T淋巴细胞亚群、补体水平和肺外表现情况。结果 实验组血清IgG、IgA、IgM水平均显著高于对照组（P0.05）；实验组心血管、肝脏、消化道、皮肤和神经系统等肺外表现发生率均高于对照组，差异有统计学意义（P0.05）。结论 难治性支原体肺炎患儿免疫系统功能严重紊乱，主要表现在免疫球蛋白、T淋巴细胞亚群和补体水平，且与肺外症状发生率密切相关，提示合理的免疫治疗有助于改善病情、缓解肺外症状、缩短病程，值得临床推广。 　　[关键词]难治性肺炎支原体肺炎；免疫球蛋白；T淋巴细胞亚群；补体 　　[中图分类号] R725.6 [文献标识码] A [文章编号] 1674-4721（2017）03（a）-0136-03 　　[Abstract]Objective To explore effect of immune function status on refractory Mycoplasma pneumonia in children.Methods 100 children with refractory Mycoplasma pneumonia from February 2014 to November 2016 were selected as experimental group；while 100 children with general Mycoplasma pneumonia were selected as control group.Levels of serum immunoglobulin，T lymphocyte subsets，complement and extrapulmonary manifestations of two groups were detected and compared by using flow cytometry and immunoturbidimetry.Results Levels of serum IgG，IgA，IgM in experimental group were obvious higher than control group （P0.05）.The incidence of xtrapulmonary manifestations such as cardiovascular，liver，digestive tract，skin and nervous system in experimental group was higher than that of the control group，and the difference was statistical significance （P0.05）.Conclusion Severe immune dysfunction in children with refractory Mycoplasma pneumonia，the main features of immunoglobulin，T lymphocyte subsets and complement levels are closely related to the incidence of extrapulmonary symptoms.It is suggested that reasonable immunotherapy can help to improve the condition，relieve the symptoms and shorten the course of disease，and is worth to popularize in clinical. 　　[Key words]Rrefractory Mycoplasma pneumonia；Immunoglobulin；T lymphocyte subsets；Complement 　　?y治性支原体肺炎（refractory Mycoplasma pneumonia，RMPP）是指支原体肺炎（Mycoplasma pneumonia，MPP）经大环内酯类抗生素治疗后，临床效果不佳，症状无明显缓解，胸片肺部阴影无显著改善甚至加重，且出现肺外表现，给儿童健康带来巨大伤害[1]。现临床针对RMPP多采用一般治疗、常规对症治疗和敏感抗生素治疗，