肺炎支原体肺炎患儿中枢神经系统损害及其机制

Central Nervous System Damage in Children with Mycoplasma Pneumoniae Pneumonia and Its Mechanism

目的观察肺炎支原体肺炎(MPP)患儿中枢神经系统(CNS)损害情况,并探讨其机制。方法收集2007年1月-2009年3月本院收治的MPP患儿325例,观察合并CNS损害的症状和体征,对有CNS损害的患儿进一步检测其血清和脑脊液中IL-8、IL-18和可溶性白细胞介素-2受体(sIL-2R)水平。以同期住院的病毒性脑炎患儿作为对照组。采用SPSS12.0软件进行统计学分析。结果325例MPP患儿中,22例(6.8%)出现CNS损害,主要表现为发热、呕吐、头痛和惊厥。MPP并CNS损害患儿血清和脑脊液中IL-8、IL-18和sIL-2R水平明显高于对照组,特别是脑脊液中IL-18和sIL-2R水平(Pa<0.01)。MPP并CNS损害患儿血清和脑脊液中IL-18与sIL-2R均呈正相关(Pa<0.01)。结论MPP合并CNS损害患儿血清和脑脊液中IL-18和sIL-2R水平明显升高,可能与肺炎支原体导致CNS损害的发生有关。

Objective To observe the central nervous system（CNS）damage in children with mycoplasma pneumoniae pneumonia（MPP）and explore its mechanism.Methods A total of 325 cases of MPP were selected to investigate the incidence of CNS damage,and the levels of IL-8,IL-18 and soluble interleukin-2 receptor（sIL-2R）in both serum and cerebrospinal fluid（CSF）were detected in those patients with CNS complications.Children with viral encephalitis at hospital during the same period were taken as control group.Use SPSS 12.0 software to analyze the data.Results There were 22 cases（6.8%）of MPP who had CNS complications,presented mainly with fever,vomiting,headache and convulsion.The levels of IL-8,IL-18 and sIL-2R were higher in MPP patients who had CNS complications than those in control group,especially the level of IL-18 and sIL-2R in CSF（Pa〈0.01）.There was a positive correlation between IL-18 and sIL-2R in both serum and CSF,respectively（Pa〈0.01）.Conclusion The levels of IL-18 and sIL-2R increase obviously in both serum and CSF in children with MPP and CNS complications,which may be involved in the CNS injury in mycoplasma pneumoniae infection.