血清炎性细胞因子、PCT和CRP在支原体与细菌性肺炎中的水平变化及临床意义

Serum level changes and clinical significance of inflammatory cytokines,PCT and CRP in mycoplasma and bacterial pneumonia

目的探讨IL-6、IL-10、降钙素原(Procalcitonin,PCT)及C反应蛋白(C-reactive protein,CRP)与儿童支原体及细菌性肺炎发病及病程的相关性。方法选择来我院就诊住院诊断为儿童肺炎的患者260例,其中诊断为支原体肺炎(A组)、细菌性肺炎(B组)各130例,同时选取相同年龄段的健康儿童110例作为正常对照组(C组)。分别抽取A、B两组患儿治疗前组、治疗后组(15±3)d及对照组(C组)空腹静脉血3mL,各组IL-6、IL-10采用酶联免疫吸附法,血清PCT采用免疫透射比浊法,CRP采用CX4型全自动生化分析仪进行检测。结果血清中IL-6的浓度:A、B组治疗前显著高于治疗后及对照组,治疗后与对照组比较差异无统计学意义。血清中IL-10的浓度:A组治疗前显著低于B组治疗前及对照组,B组治疗前与对照组比较差异无统计学意义;A组治疗后高于治疗前,但仍低于B组治疗后与对照组,B组治疗前与治疗后及对照组比较差异无统计学意义。治疗前,B组的PCT水平高于C组,亦高于A组。A组与C组比较差异无统计学意义。治疗后,A组的PCT水平与治疗前和C组比较差异无统计学意义,B组的PCT水平低于治疗前,但仍高于A组和C组。治疗前,A组及B组的CRP水平均高于C组,B组的CRP水平高于A组。治疗后,A组及B组与治疗前相比均显著降低。结论儿童肺炎的发生发展中,IL-6和IL-10、CRP和PCT有良好的指导作用。

Objective To explore the correlation of IL-6,IL-10,PCT and CRP in children with mycoplasma and bacterial pneumonia in children.Methods 260 children diagnosed as pneumonia in our hospital were included,including 130 cases of mycoplasma pneumonia（group A）and 130 cases of bacterial pneumonia（group B）.110 healthy children at the same age were chosen as the normal controls（group C）.3ml of fasting venous blood of the patients in each group before and after treatment was taken for IL-6and IL-10 detection with enzyme-linked immunosorbent method,serum PCT with immune transmission turbidimetry,and CRP with CX4 fully automatic biochemical analyzer.Results a）The levels of serum IL-6in group A and B were significantly higher than that in group C before treatment,which decreased and showed no significant difference from that of the controls after treatment.b）The level of serum IL-10 in group A was significantly lower than those in group B and C before treatment,which increased after treatment yet still lower than those of group B and C;The IL-10 level of group B showed neither significant change after treatment,nor obvious difference from that of group C.c）Before the treatment,the PCT level of group B was higher than those of group C and A,which decreased after treatment,yet still higher than group A and C.No significant difference was observed between Group A and C either before or after treatmnet.d）Before treatment,the CRP levels in group A and group B were higher than in group C,and that of group B was higher than that of group A.After treatment,the levels in both group A and group B were significantly lower.Conclusion IL-6,IL-10,CRP and PCT have good indicative effects and can be used as the guidance for clinical diagnosis and treatment of pneumonia in children.