肺炎支原体IgM、IgG、血清C-反应蛋白和降钙素原检测在儿童支原体肺炎诊断和治疗中的应用

Detection of mycoplasma IgM,IgG,serum C-reactive protein and procalcitonin in diagnosis and treatment of children mycoplasma pneumonia

目的探讨肺炎支原体肺炎(MPP)患儿肺炎支原体(MP)Ig M、Ig G、血清C-反应蛋白(CRP)和降钙素原(PCT)检测的临床意义。方法 MPP患儿88例根据肺部影像学表现分为大叶性肺炎组(n=33)和支气管肺炎组(n=55),另选取同期体检健康儿童30例为对照组。对比3组MP-Ig M、MP-Ig G、血清CRP和PCT检测结果,同时分析2组MPP患儿入院时和退热后3 d血清CRP、PCT变化情况。结果 MPP患儿MP-Ig M、MP-Ig G、CRP和PCT阳性率高于对照组(P<0.01);除MP-Ig G外,MPP患儿2组其余指标差异无统计学意义。入院时,大叶性肺炎组和支气管肺炎组血清CRP和PCT水平均显著高于对照组(P<0.05),但2组间差异无统计学意义(P>0.05);退热后3 d,2组血清CRP和PCT值均较入院时显著降低(P<0.05),支气管肺炎组血清CRP和PCT水平与对照组比较,差异无统计学意义(P>0.05)。结论 MPP患儿体内存在不同程度的体液免疫和细胞免疫功能紊乱,联合肺炎支原体Ig M和Ig G、血清CRP、PCT监测有助于MPP早期诊断、感染程度以及疗效的监测。

Objective To explore the clinical significance of detection of mycoplasma （MP） IgM, IgG, serum C-reactive protein （CRP） and procalcitonin （PCT） in diagnosis and treatment of children mycoplasma pneumoniae pneumonia （MPP）. Methods A total of 88 children with MPP were divided into Lobar pneumonia group （ tz = 33） and bronchial pneumonia group （ n = 55 ） ac- cording to pulmonary iconographical manifestations. Additionally, 30 healthy children at the same period were selected as control group. The detecting results of MP-IgM, MP-IgG and serum CRP and PCT of 3 groups were compared and the changes of CRP and PCT on admission and 3 d after a- batement of fever were analyzed. Results The positive rates of MP-IgM, MP-IgG, CRP and PCT were higher in children with MPP than in patients in control group （P〈0.01）. Except from MP- IgG, there were statistical significances in rest indicators between MPP groups. The levels of serum CRP and PCT were higher in MPP groups than in control group on admission （P 〈 0.05）, but no differences between MPP groups （ P 〉 0.05）. Three days after abatement of fever, the levels of serum CRP and PCT decreased significantly in MMP groups （P 〈 0.05） and no difference between bronchial pneumonia group and control group （P 〉 0.05）. Conclusion Immune dysfunction of hu- moral immunity and cellular immunity exists in children with MPP in different degrees. The combi- nation of MP-IgM, MP-IgG, CRP and PCT is conductive to the early diagnosis, infectious degree and monitoring of efficacy for MPP.