支原体肺炎患儿D-二聚体、免疫功能变化及其意义

Changes of D-Dimer and Immunoglobulin in Children with Mycoplasma Pneumonia and its Significance

目的探讨肺炎支原体肺炎(mycoplasma pneumonia,MPP)患儿T淋巴细胞亚群、D-二聚体和免疫球蛋白的变化及其临床意义。方法应用流式细胞仪检测技术测定肺炎支原体肺炎患儿(MPP组,n=50)和健康儿童(正常对照组,n=50)CD3^+、CD4^+、CD8^+、CD4^+/CD8^+的水平;免疫比浊法检测2组中D-二聚体水平;免疫透射比浊法检测2组的血清免疫球蛋白(IgA、IgM、IgG)水平。结果T淋巴细胞亚群检测结果:与正常对照组比较,MPP组外周血CD3+和CD4+细胞降低差异显著(P<0.001)、CD8+细胞升高无显著差异、CD4^+/CD8^+比值降低无显著差异。D-二聚体水平检测结果:与正常对照组比较,MPP组D-二聚体水平升高差异显著(P<0.001)。免疫球蛋白检测结果:MPP组血清IgA、IgM较正常对照组相比,差异显著(P<0.05),MPP组血清IgG与正常对照组比较差异无统计学意义。结论肺炎支原体肺炎患儿体内免疫功能紊乱,受到不同程度抑制,凝血功能异常,故支原体肺炎患儿除了常规抗肺炎支原体治疗外,需根据不同的临床症状和疾病发展情况,监测D-二聚体水平的表达,并加强对免疫系统的调节和治疗。

Objective To explore the changes of T-lymphocyte subsets,D-Dimer and immunoglobulin in mycoplasma pneumonia children and its significance.Methods The levels of T lymphocyte subsets (CD3 +、CD4 +、CD8 +、CD4 +/CD8 +)in 50 children with mycoplasma pneumonia (MPP Group)and 50 healthy children were detected by flow cytometry;The levels of D-Dimer were detected by immunoturbidimetry;The levels of serum immunoglobulin were detected by immune turbidimetric method.Results The results of T lymphocyte subsets:Compared with normal control group, CD3 +and CD4 +peripheral blood cells in MPP group were significantly declined(P<0.001)、CD8 +cells were increased slightly,but with no significant difference、CD4 +/CD8 +ratios were decreased slightly.The results of D-Dimer:Compared with normal control group,the levels of D-Dimer in MPP group were significantly escalated(P<0.001).The results of immunoglobulin:IgA and IgMin MPP group were both significantly higher than those of normal group,but IgG was not different from that in normal group.Conclusion Children with mycoplasma pneumonia have immune disorder,which may generate abnormal clotting.Therefore,besides the conventional anti-mycoplasma pneumonia treatment,we need to detect the levels of D-Dimer according to the clinical symptoms and disease progression and strength the regulation and treatment of the immune system.