儿童咳嗽变异性哮喘与反复肺炎支原体感染的相关性研究

Correlation between cough variant asthma in children and repeated mycoplasma pnenumonia infection

目的探讨儿童咳嗽变异性哮喘(CVA)与反复肺炎支原体(MP)感染的相关性。方法选择2014年1月至2016年3月我院住院的CVA患儿60例为A组,MP感染患儿60例为B组,同期以咳嗽为主要症状的反复上呼吸道感染60例患儿为对照组C组。3组患儿均行肺炎支原体抗体(MP-IgM)检测,比较各组中MP阳性率及MP阳性与年龄及性别的相关性,同时观察3组患儿血清总IgE水平及血嗜酸粒细胞(EOS)计数的差异性。结果 (1)A组和C组的MP-IgM阳性率分别为43.33%和23.33%,A组MP-IgM阳性率明显高于对照组(P<0.05)。年龄越大,CVA患儿的MP-IgM阳性率越高。男童MP-IgM阳性率高于女童;(2)A、B两组外周血EOS及血清总IgE水平明显高于对照组(P<0.05);(3)ROC曲线示,EOS曲线下面积为0.860,最佳阈值为1.08×10~9/L,敏感度为0.852,特异度为0.780;总IgE曲线下面积为0.776,最佳阈值为196.53IU/mL,敏感度为0.795,特异度为0.834;结论 MP感染与小儿CVA有密切相关性,可以将MP-IgM检测作为CVA患儿的常规筛查项目,EOS及总IgE对CVA具有较高的预测价值。

Objective To observe the correlation between cough variant asthma （CVA） in children and repeated mycoplasma pnenumonia （MP） infection. Methods From January 2014 to March 2016, 60 CVA children in our hospital were divided into the group A, 60 cases of mycoplasma pnenumonia infection children were divided into group B, and 60 children with repeated upper respiratory tract infection were selected as the control group （group C）. MP-RIgM test was applied to the three groups. The MP positive rate in the three groups and the correlations between MP positive rate with age and gender were analyzed. Meanwhile, the blood acidophilic granulocyte count and serum total IgE were tested in the three groups. Results （ 1 ） The MP-RIgM positive rate of the group A and C were 43.33% and 23.33% respectively. The positive rate of the group A was significantly higher than that of the group C （P 〈 0. 05）. And with age increasing, the MP-RIgM positive rate were higher in children with CVA, and the CVA MP-RIgM positive rate of boys was higher than that of the girls. （2） The levels of peripheral blood eosinophilia （EOS）, granulocyte count and serum total IgE were significantly higher in the group A and B than in the group C （P 〈0. 05）. （3） ROC curve analysis revealed that the optimal cutoff of EOS to predict CVA was 1.08 × 10^9/L （AUC = 0. 852, sensitivity = 0. 780, specificity = 0. 754）, and the optimal cutoff of total IgE to predict CVA was 196. 53 IU/mL （AUC = 0. 776, sensitivity = 0. 795, specificity = 0. 834）. Conclusion Mycoplasma pneumoniae in- fection is closely correlated with CVA, which suggests that MP IgM test should be included as children with CVA routine inspection project, and the therapy of EOS and total IgE have a higher diagnostic value in children＇s CVA.