婴幼儿肺炎支原体感染免疫功能动态变化

Change in immunologic function of infants with Mycoplasma pneumonia infection

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的变化,并与体检健康儿童(正常对照组)进行比较。方法分别在患儿急性期入院后2 h内(抗感染治疗前)以及大环内酯类药物治疗2～4周后且临床及影像学症状均显著好转时采集外周静脉血分别检测相关指标。结果 MPP组急性期CD4+T细胞比例、CD4+/CD8+比值、NK细胞比例以及补体C3、C4的水平均显著低于恢复期患儿和正常对照组(P<0.05);CTLA-4+T细胞比例显著低于恢复期患儿(P<0.05);CD8+T细胞、B细胞以及IgA、IgM、IgE水平均显著高于恢复期患儿和正常对照组(P<0.05)。MPP组与正常对照组的CD3+T细胞比例及IgG水平差异无统计学意义(P>0.05)。结论婴幼儿MPP急性期免疫功能明显紊乱,恢复期免疫功能仍存在一定问题,对MPP患儿对症治疗的同时应进行适度的免疫调节治疗,以缩短病程,提高患儿的康复率。

Objective To investigate the change in immunologic function of infants with Mycoplasma pneumonic pneumonia （MPP） in the acute and recovery phase, and compare with normal healthy children. Methods Patient＇s peripheral blood was withdrawn respectively when they admitted in hospital within 2 hours in the acute phase （be- fore receiving treatment with antimicrobial agents）, having received macrolides for 2 - 4 weeks and when clinical and radiographic signs significantly improved , then all specimens were detected. Results Compared with healthy infants and infants in the recovery phase, the proportion of CD4 ＋ T cells ,CTLA - 4 ＋ T cells,CD4 ＋ /CD8 ＋, NK cells and the level of C3,CA in patients with acute MPP were significantly lower （P〈0. 05） ; the proportion of CD8 ＋ T cells,B cells and the levels of IgA,IgM,IgE were significantly higher （P〈0. 05）. The proportion of CD3 ＋ T ceils and the levels of IgG were not statistically different between two groups （P〉0. 05）. Conclusion The immunologic function of patients are disordered in the acute phase of MPP, and still exist a certain degree of disorder during convalescence, immunological regulatory treatment should be given to infants with MPP , so as to reduce treatment course and improve convalescence.