肺炎支原体肺炎婴幼儿不同病期免疫功能、细胞因子、血小板活化因子乙酰水解酶基因多态性变化

Changes of Immunologic Function,Cellular Factor,Genotype and Activities of Platelet Activating Factor-Acetylhydrolase in Different Stadium of Mycoplasma Pneumoniae Pneumonia of Infant

目的探讨婴幼儿肺炎支原体肺炎（MPP）急性期与恢复期免疫功能、细胞因子、血小板活化因子乙酰水解酶（PAF-AH）基因多态性的动态变化。方法MPP组235例,年龄5个月-3岁;急性期为病程d1-9,恢复期为愈后8-20周。对照组为正常健康儿童90例,6个月-3岁。以酶联免疫吸附试验（ELISA）测定IgA、IgM、IL-2与IL-2受体（IL-2R）、IL-4、IL-8、干扰素-γ（IFN-γ）;速率散射法测定IgG及其亚群;单相琼脂扩散法测定补体C3、C4;PGE法测定循环免疫复合物（CIC）;APAAP法测定T细胞亚群;特异性聚合酶链式反应（AS-PCR）法与PAF-AH试剂盒测定PAF-AH基因多态性与酶活性。对婴幼儿MPP急性期、恢复期与对照组的结果进行比较分析。结果MPP组急性期IgA、IgM、补体C4、CIC、CD8＋、IL-2R、IL-6、IL-8、INF-γ、INF-γ/IL-4均高于恢复期与对照组（Pa〈0.05）,补体C3、CD3＋、CD4＋、CD4＋/CD8＋、IL-2均低于恢复期与对照组（Pa〈0.05）,IgG及亚群各组间差别无统计学意义（Pa〉0.05）。PAF-AH突变基因型频率、突变等位基因频率、PAF-AH酶活性各组差别无统计学意义（Pa〉0.05）。结论婴幼儿MPP免疫功能变化的主要表现为Th1免疫应答增强,Th2免疫应答减弱,细胞因子改变,但多数免疫学指标及细胞因子恢复较快。婴幼儿MPP发病与PAF-AH基因型无关,但急性期PAF-AH酶活性有下降趋势。

Objective To explore the changes of immunologic function,cellular factor,genotype and activities of platelet activating factor-acetylhydrolase（PAF-AH） in Mycoplasma pneumoniae pneumonia（MPP） of infant in acute stage and restoration stage.Methods MPP group： 253 MPP of infant from 5 months to 3 years old.Acute stage was course of disease from 1 to 9 days,and restoration stage was in cure from 8 to 20 weeks.Control group：90 healthy infant from 6 months to 3 years old.IgA,IgM,interleukin-2（IL-2）,soluble interleukins 2 receptor（sIL-2R）,IL-4,IL-6,IL-8,interferon-γ（IFN-γ） were confirmed with enzyme-labeled immunosorbent assay（ELISA）,IgG subgroup was confirmed with rat scattered nephelometry, alexin C3,C4 were confirmed with agar geldiffusion test,circulating immune complex（CIC） was confirmed with PGE,T cell subpopulation was confirmed with APAAP,PAF-AH genotype and activities were confirmed with AS-Polymerase chain reaction（AS-PCR） and PHF-AH kit,so as to analyse the results of acute stage,restoration stage and control group.Results IgA,IgM,alexin C4,CIC,CD8,sIL-2R,IL-6,IL-8,IFN-γ,IFN-γ/IL-4 were significantly higher than restoration stage and control group（Pa〈0.05）,and alexin C3,CD3＋,CD4＋,CD4＋/CD8＋,IL-2 were significantly lower than restoration stage and control group（Pa〈0.05）,there was no significance difference between IgG and subgroup in statistics（Pa〉0.05）,there was no significance diffe-rence between PAF-AH frequency of genotype mutation and allele mutation and activity of PAF-AH in statistics（Pa〉0.05）.Conclusions Immunologic function alteration of MPP of infants is showed mainly that Th1 immunologic response is raised,Th2 immunologic response is abated,the cellular factor are changed horizontally,but the immunology index and cellular factor are recovered quickly.There are no relations between MPP of infant and PHF-AH genotype,but there is a downward trend in activity of PHF-AH in acute stage.