合并支原体感染的大叶性肺炎患儿肺泡灌洗液中白细胞介素-17、白细胞介素-33检测及意义

Levels of IL-17 and IL-33 in bronchoalveolar lavage fluid of children with labor pneumonia complicated with Mycoplasma pneumoniae and their clinical significance

目的检测合并支原体感染大叶性肺炎患儿支气管肺泡灌洗液(BALF)中白细胞介素(IL-17)、白细胞介素(IL-33)的水平,探讨其与支原体感染疾病严重程度及肺炎支原体(MP)-DNA的关系。方法选取确诊为大叶性肺炎并行肺泡灌洗术的74例患儿,根据免疫荧光定量MP-DNA结果,其中合并支原体感染62例,无支原体感染12例,根据临床肺部感染评分法(CPIS)将合并支原体感染组分为轻症组(49例),重症组(13例),再根据胸腔B超结果将轻症组分为合并胸腔积液组(16例)、无胸腔积液组(33例),双抗体夹心ELISA法检测患儿BALF中IL-17、IL-33的水平。结果 IL-17、IL-33在合并MP感染的大叶性肺炎患儿BALF中不同程度表达,重症组BALF中IL-17水平高于轻症组,差异有统计学意义(P<0.05),且患儿BALF中IL-17与MP-DNA滴度呈正相关(r=0.391,P<0.05);轻症组无胸腔积液组患儿BALF中IL-33水平高于合并胸腔积液组,差异有统计学意义(P<0.05)。结论合并支原体感染的大叶性肺炎患儿BALF中IL-17可以反映疾病严重程度及MP-DNA滴度,BALF中IL-33升高可能有助于减轻胸膜炎症反应。

[Objective] To explore the levels of IL-33 and IL-17 in bronchoalveolar lavage fluid （BALD of children with labor pneumonia complicated with Mycoplasma pneumoniae （MP） infection and their signifi- cance. [Methods] A total of 74 children with labor pneumonia were divided into merged with Mycoplasma pneumoniae infection group （62 cases） and no Mycoplasma pneumoniae infection group （12 cases）. According to the clinical pneumonia infection score （CPIS）, the group merged with Mycoplasma pneumoniae infection was further divided into CPIS I〉 6 group and CPIS 〈 6 group. Meanwhile, according to the results of B ultra- sonography, the CPIS 〈 6 group was divided into the group with pleural effusion and the group without pleu- ral effusion. ELISA was used to detect IL-17 and IL-33 levels in BALF. [Results] The IL-17 and IL-33 levels of the children whose CPIS i〉 6 were higher than those of children whose CPIS 〈 6 （P〈0.05）. IL-17 level in BALF was related with MP-DNA （r=0.391, P〈0.05）. IL-33 in the group with pleural effusion was significantly lower than that in the group without pleura] effusion （P〈 0.05）. [Conclusions] IL-17 can reflect the severity of labor pneumonia merged with pleural effusion, and it also relates to MP-DNA. Low IL-33 in- dicates that the kid may merge with pleural effusion.