小儿肺炎支原体肺炎不同病期免疫功能的动态变化

Dynamic changes in the immune function of children with mycoplasma pneumoniae pneumonia on differ- ent disease stages

目的探讨d,JL肺炎支原体肺炎（mycoplasma pneumoniae pneumonia，MPP）不同病期T细胞亚群、免疫球蛋白、补体的变化及其临床意义。方法应用流式细胞术、免疫散射比浊法检测28例MPP患儿急性期及恢复期外周血T细胞亚群（CD3、CD4、CD8）、免疫球蛋白（IgG、IgA、IgM）、补体（c3、C4）水平，并与25例健康儿童（对照组）进行比较。结果MPP患儿急性期外周血CD3、CD4、CD8、CD4／CD8分别为（58．71±11．63）％、（32．36±8．06）％、（28．19±6．23）％、1．15±0．41，恢复期分别为（61．29±10．17）％、（34．14±7．22）％、（26．47±6．01）％、1．29±0．37。急性期与恢复期MPP患儿CD4、CD4／CD8比值均低于对照组[（39．53±6．16）％、1．83±0．49]，CD8水平高于对照组（1．83±0．49），差异均有统计学意义（P均〈0．01）。急性期CD3水平与对照组[（63．03±12．32）％]比较差异有统计学意义（P〈0．01），而恢复期无明显差异（P〉0．05）。MPP患儿急性期外周血免疫球蛋白与对照组比较，血清IgG[（14．50±3．86）∥L]、IgM[（1．67±0．56）g／L]与对照组[（7．92±2．62）g／L、（1．06±0．32）g／L]比较明显增高，c3[（0．83±0．42）g／L]水平低于对照组[（1．37±0．33）∥L]，差异均有统计学意义（P〈0．05）；而IgA、C4水平与对照组比较差异无统计学意义（P〉0．05）。结论MPP患儿存在细胞免疫和体液免疫失调。检测T细胞亚群、免疫球蛋白、补体的变化，有利于判断临床治疗效果，为临床应用免疫调节剂提供理论依据。

Objective To investigate the changes and functions of T lymphocyte subsets, immune globulin and complement in children with mycoplasma pneumoniae pneumonia （MPP） on different disease stages. Methods The levels of T lymphocyte subsets of CD3, CD4, CD8 and immunoglobulin （ IgG, IgA IgM） ,and complement （C3, C4 ） in the peripheral blood were detected on acute and recovery stages in 28 children with MPP by flow cytometry and immune nephelometry. Twenty-five healthy children were recruited as control group. Results Among these subjects of MPP children on acute stage, the levels of CD3, CD4, CD8,and CD4/CD8 in the peripheral blood were （58.71 _± 11.63）%, （32.36 ± 8.06）%, （28.19 ± 6. 23 ） % and 1.15 ± 0. 41 respectively, and on recovery stage, the levels of CD3, CD4, CD8, and CD4/CD8 were （61.29 ± 10. 17） %, （34. 14± 7. 22） %, （26.47 ± 6. O1 ） %, and 1.29 ± 0. 37 respectively. Both on a- cute stage and on recovery stage of MPP children, the levels of CD4, CD4/CD8 were significantly lower than those in control group E （39. 53 ± 6. 16） %, 1.83 ± 0.491, and CD8 was significantly higher compared to the control group （ 1.83 ± 0.49 ）, P 〈 0. 01. CD3 were lower than that in control group E （ 63.03 ± 12. 32 ） %] on acute stage （ P 〈 0. 01 ）, and no significant difference on recovery stage （ P 〉 0. 05 ）. During the acute stage of MPP,IgG E （14. 50 ±3.86） g/L3 and IgM g/L （1.67 ±0. 56） g/L3 were obviously higher than those in con- trol group （7.92±2.62） g/L,（1.06±0.32） g/L,P〈0.01）,and C3 I（0.83 ±0.42） g/L3 were obvi- ously lower compared to the control group [ （ 1.37 ±0. 33） g/L,P 〈0. 053. There were no significant differ- ences of IgA and C4 between MPP and control groups （ P 〉 0. 05 ）. Conclusion Children with MPP had cel- lular immune and humoral immune disorders. Through the detection of T lymphocyte subsets, immunoglobu- lin and complement,it will be helpful to judge the effectiveness of clinical treatment, which provides a theo- retical basis for the clinical application of immune regulators.