支原体肺炎血清黏附分子变化及其临床意义

Clinical Significance of Serum Levels of Soluble Intercellular Adhesion Molecule-1 in Children with Mycoplasma Pneumonia

目的探讨不同临床表现支原体肺炎(MPP)的血清黏附分子变化及其与哮喘发病的关系。方法采用酶联免疫吸附实验(ELISA)法检测了46例MPP喘息组(Ⅰ组)、38例MPP非喘息组(Ⅱ组)和40例健康儿童(对照组)血清可溶性细胞间黏附分子(sICAM-1)水平,同时检测3组患儿诱导痰中嗜酸粒细胞计数(EOC),追踪观察6个月内Ⅰ组和Ⅱ组患儿哮喘发作人数及发生率。结果MPP喘息组和非喘息组血清sICAM-1水平分别为(558.6±66.42)mg/L,(425.64±68.56)mg/L,诱导痰中EOC分别为(8.4±1.8)个/100,(5.0±1.4)个/100;对照组血清sICAM-1水平和诱导痰中EOC比较差异均有显著性(P<0.01)。两组MPP缓解期血清sICAM-1水平与诱导痰中EOC比较差异均无显著性。6个月内喘息组和非喘息组哮喘发作人数差异无显著性(P>0.05)。结论血清sICAM-1在MPP时明显升高,喘息组表现更为显著,其动态变化与嗜酸性粒细胞计数呈正相关,sICAM-1在支原体感染诱发哮喘的发病机制中起重要作用。

Objective To inw, stigale the levels of serum soluble intereellular adhesion molecule-1 （ sICAM-1 ） in children with mycoplasma pneumonia（MPP） in different clinical periods and to evaluate the role of sICAM-1 in pathogenesis of MP-induced asthma. Methods The levels of serum sICAM-1 were detected via enzyme linked immunosorbent assay（EI.ISA） aud eosinophilie granulocyte counts （EOC） in induced sputum were measured in 46 children with MP-indueed asthmatie acute attack（ group Ⅰ ）,38 chihtreu with simple MPP （non-asthma） （ group Ⅱ ） and 40 heahhy controls （ group Ⅲ ） in acute and remission periuds,respeelively. The ehihh＇en in group Ⅰ and Ⅲ were followed up tor 6 months and observed the incidence of asthmatic attacks. Results The levels of serum sICAM-1 and EOC in induced sputum in three groups were （ 558.6 ± 66.42 ） mg/L, （ 425.64 ±68.56 ） mg/L, （ 206.26 ± 56.24 ） mg/L, （ 8.4 ±1.8 ） / 100, （ 5.0 ＋ 1.4 ） / 100 cells in acute period,there were signifieaut differences between group [ and group Ⅱ and group Ⅲ （P〈 0. 01）; in remission period,the levels of serum sICAM-1 and EOC in induced sputum in two M PP groups were （ 338.51 ±60.38 ） mg/L, （ 325.64± 68.56 ） mg/L, （ 5.2 ± 2. 8）, （4.8 ±2.6）/100 cells,there were not differences between group Ⅰ and group Ⅱ （P 〉0.05）. Both levels of serum sICAM-1 and EOC in induced sputum in group [ and group n were significantly higher titan that in group Ⅲ （P 〈0.01 ）. After 6 months,28 eases were diagnosed as asthma（ 60.9% ） in group Ⅰ and 22 eases （ 57.9% ） in group Ⅱ , no difference was found statistically （ P 〉 0. 05 ）. Conclusion Our observations demonstrate that the levels of serum sICAM-1 in children with MPP especial induced asthmatic attack are increased significantly and sICAM-1 plays a important role in pathogenesis of MP-induecd asthma.