小儿轻中度支原体肺炎激素治疗分子水平研究

Children with mild to moderate pneumonia molecular level study of hormone therapy

目的探讨激素对小儿轻、中度支原体肺炎(MPP)在分子水平方面的作用机制,为小儿轻、中度MPP的激素使用方案提供实验室证据,初步形成小儿轻、中度MPP临床应用糖皮质激素的优化治疗方案。方法对50例小儿轻、中度MPP患儿血清IFN-γ、IL-4、IL-17、IL-21和TGF-β在激素治疗前后进行动态检测,并与对照组50例进行比较。结果患儿血清中细胞因子IFN-γ、IL-4、IL-17、IL-21水平在激素治疗后降低;患儿血清中TGF-β水平在激素治疗后升高。结论激素既可抑制TH1、TH2、TH17、TfH细胞活化,抑制血清中细胞因子IFN-γ、IL-4、IL-17、IL-21的产生;同时也促进Treg细胞的增殖,导致TGF-β分泌增加,从而抑制支原体感染导致的炎症反应。激素+阿奇霉素治疗小儿轻、中度支原体肺炎疗效优于单用阿奇霉素,且能有效地阻断向中、重度支原体肺炎转化的通路。

Objective To probe into mechanism of hormone on a molecular level and provide scientific basic for the clinical application of mild to moderate mycoplasma pneumonia in children （MPP）. Methods The 50 cases of mild to moderate mycoplasma pneumonia in children patients were collected blood to detect IFN-Y,IL-4,IL-17,IL-21 and TGF-13 before and after hormone treatment, and compare with the positive control group. Results The numerical value of IFN-~,IL-4,IL-17,IL-21 in blood are reduce after treatment,The numerical value of TGF-13 in blood are rise. Conclusions Adrenal cortex hormone can restrain cell activation of TH 1 ,TH2 ,TH 17,TfH, restrain the produce of IFN-y, IL-4, IL- 17, IL-21 in blood; and promote the proliferation of Treg cell,lead to TGF-13 Increased secretion, restrain inflammatory reaction that mycoplasma infection lead to. Adrenal cortex hormone and Azithromycin treat mild to moderate mycoplasma pneumoniae in children on the basis of treatment is much better than the treatment with Azithromyein. and prevent it to translate into moderately severe myeoplasma pneumoniae.