117例儿童支原体肺炎免疫功能测定与临床分析

Determination and clinical analysis of immune function of 117 infants infected with mycoplasma pneumoniae.

目的了解肺炎支原体(MP)感染儿童免疫功能与临床特点。方法用免疫学方法对117例发热、咳嗽、肺炎支原体IgM或IgG阳性患儿的免疫功能进行测定并分析其临床特征。结果支原体肺炎患儿血清CD3、CD4(51.63±5.74、33.05±4.28)较正常对照组(66.32±5.17、40.95±4.82)明显降低(P<0.05),血清免疫球蛋白则与正常对照组比较差异无显著性。117例肺炎支原体感染的儿童中,间断性咳嗽咳痰98例,低热盗汗54例,腹泻39例,肾脏损害7例,肝脏损害16例,皮肤粘膜损害8例,关节疼痛5例,心电图异常改变11例,误诊为其它疾病91例。结论肺炎支原体感染儿童的细胞免疫功能下降,而体液免疫无明显改变。肺炎支原体感染儿童临床表现复复杂多样,应及时查血MP-IgM作出早期诊断,抗感染药物单用疗效差,应用大环内酯类药物合用头孢类疗效较好。

Objective To investigate the immune function and clinical feature of 117 child cases with Mycoplasma Pneumoniae. Methods Immune function of the 117 child cases with mycoplasma pneumoniae, IgM or IgG positive , fever, cough was determined with immunologic approach and its clinical feature was observed and analyzed, Results The results showed the level of CD3, CD4（51.63 ±5.74, 33.05 ± 4.28） in children with mycoplasma pneumoniae was obviously lower than that of the normal control （66.32 ± 5.17, 40.95± 4.82, P 〈 0. 05）, and there was no significant difference in immunoglobulin in serum compared with the normal （P 〉 0.05 ） of 117 child cases with mycoplasma pneumoniae, there was 98 cases sufferdfrom intermittent coughing and expectoration, 54 cases had low- grade fever night- sweat, 39 cases had diarrhea, 7 cases had kidney damage, 16 cases had liver damage, 8 cases had skin and mucosa damage, 5 cases had arthralgia, 11 electrocardiographic abnormality cases, and 91 cases were misdiagnosised as other deseases. Conclusion Cellular immune function of children with mycoplasma pneumoniae was reduced and no change in humoral immunity function was observed. The clinical manifestations of children with mycoplasma pneumoniae displayed multiplicity and complicated. Children with mycoplasma pneumoniae should check blood promptly for MP- IgM for early diagnosis and curative effect of anti - infection alone was not satisfactory. It was useful for macrolides gathering with cephalosporins to treat mycoplasma pneumoniae.