AECOPD患者合并肺炎支原体感染情况及其对人体免疫功能的影响分析

Analysis of AECOPD patients with Mycoplasma pneumoniae infection and its effect on human immune function

目的研究分析慢性阻塞性肺疾病急性加重期（AECOPD）患者合并肺炎支原体（MP）感染后的临床特征及对患者免疫功能的影响作用。方法回顾性分析本院呼吸内科收治的120例AECOPD患者的临床诊治资料，根据是否合并MP感染分为MP组44例和非MP组76例，整理分析2组患者的临床特征及相关免疫学指标的差异。结果MP组患者的发热、咳嗽发生率显著高于非MP组且差异均有统计学意义（χ^2=11．398、13．895，P值均〈0.05）。MP组和非MP组的X线胸片表现（单侧肺炎、双侧肺炎及肺纹理增粗）差异均无统计学意义（χ^2=2．472、0．473、1．938，P值均〉0．05）。MP组和非MP组的外周血IgM水平差异均无统计学意义（t=0．603，P〉0．05），MP组患者的IgG水平显著高于非MP组患者，IgA水平显著低于非MP组患者（t=22．901、10．701，P值均〈0．05）。MP组和非MP组的外周血TNF-α、IL-6水平差异均无统计学意义（t=0．917、1．140，P值均〉0．05），MP组患者的IFN-γ水平显著低于非MP组患者（t=3．916，P〈0．05）。结论AECOPD患者合并MP感染的发热较长、咳嗽较为顽固，同时引起免疫应答紊乱，抑制IFN-γ的分泌。

Objective The clinical characteristics of acute exacerbation chronic obstructive pulmonary disease （AECOPD） patients with Mycoplasma pneumoniae （MP） infection and the influence of immune function in patients with AECOPD were studied. Methods Retrospective analysis of the clinical data of 120 patients with AECOPD in our hospital, according to whether the MP infection was divided into MP group and non MP group of 76 cases, the clinical characteristics of the two groups were analyzed. Results The fever and cough in MP group were significantly higher than that in non MP group and the difference was statistically significant （χ^2=11.398,13. 895, all P〈0.05）. MP group and non MP group of chest X-ray manifestations （unilateral pneumonia, bilateral pneumonia and pulmonary texture increased crude） were not statistically significant （χ^2 = 2. 472,0. 473,1. 938, all P〉0.05）. MP group and blood IgE levels of non-MP group differences are not statistically （ t=0. 603, P 〉 0.05）, MP group of patients with IgG levels were significantly higher than the non-MP group were significantly lower than the IgA level non-MP patients （ t = 22. 901, 10. 701, all P 〈 0.05）. MP group and non MP group of peripheral blood TNF-α, IL-6 level differences were not statistically significant （ t =0. 917,1. 140, all P〉0.05） and MP group of patients with IFN-γ levels significantly lower than non MP group （ t = 3. 916, P〈0.05）. Conclusions AECOPD patients with MP infection with fever, cough is more stubborn, and cause immune response disorders, inhibit the secretion of IFN-γ.