小儿肺炎支原体肺炎的细胞免疫和流行病学分析

Cellullar immunity and epidemiologic analysis of pediatric patients with Mycoplasma pneumonia

目的 探讨肺炎支原体肺炎的发病机理，特别是与机体免疫功能紊乱的关系。方法对９０ 例住院的支原体肺炎患儿，根据其 Ｘ 线肺部受侵程度，分为重症组和轻症组，并设立了对照组，分别检测了各组极期和恢复期的 Ｔ 细胞亚群、血清可溶性白细胞介素－ ２ 受体（ Ｓ Ｉ Ｌ－ ２ Ｒ） 及天然杀伤细胞（ Ｎ Ｋ） 数。结果 肺炎支原体肺炎极期和恢复期 Ｃ Ｄ４ 均下降， Ｃ Ｄ８ 极期和恢复期均上升（ｔ ＝ ２ ．６３ ，２ ．６６ 和２ ．７７ ，３ ．３６ ， Ｐ＜ ０ ．０５） 。全部病人，无论极期还是恢复期 Ｓ Ｉ Ｌ－ ２ Ｒ 均显著高于正常，而在病的极期变化尤为明显（ｔ＝ ５ ．２６ ，３ ．１９ ， Ｐ＜ ０ ．０１） 。检测还显示： Ｓ Ｉ Ｌ－ ２ Ｒ 与病情有关，病情越重，增高越明显。结论 患支原体肺炎时存在细胞免疫功能紊乱，且检测 Ｓ Ｉ Ｌ－ ２ Ｒ 的水平可作为监测其严重程度的指标。流行病学资料表明发病年龄以１０ ～１４ 岁为多发。

Objective To understand the of immuno-reactions of pediatrics patients with Mycoplasma pneumonia. Methods 90 patients suffered from M.pneumonia were administered and divided into three groups:mild group, severe group, and normal control group. T cell subset parameters, natural killer cell and the serumsoluble interleukin-2 recepter of all of above were determined. Results Data showed:CD 4 decreased at both acute and recovery stage of M.pneumonia, while CD 8 remarkably increased ( t=2.63,2.66,2.77,3.36,P<0.05 ).SIL-2R level of all patients also greatly increased ( t= 5.26,3.19,P <0.01), especially in the serious group. Conclusion There are disturbances of cell- immune in M.pneumonia. The level of SIL-2R can serve as monitor on the degree of severeness of M.pneumonia. The incidence M.pneumonia appeared highest in the 10-14 year-old group.