儿童难治性肺炎支原体肺炎血清总IgE水平升高的临床意义

Clinical significance of increase of serum total IgE level in children with refractory Mycoplasma pneumoniae pneumonia

目的探讨难治性肺炎支原体肺炎(RMPP)血清总IgE水平与临床表现的相关性及对RMPP患儿早期识别的意义。方法选取天津市儿童医院呼吸二科2016年1-10月收治的临床确诊为RMPP患儿60例检测血清IgE水平,根据IgE水平将患儿分为IgE升高组40例(试验组)和IgE正常组20例(对照组),分析两组患儿临床表现、实验室指标、影像学和纤维支气管镜检查结果的差异。结果试验组患儿较对照组患儿发生一过性喘息、血清CRP>40mg/L的比例较高,胸部影像学上发生多叶病变和胸腔积液的比例较高,差异均有统计学意义(P<0.05);同时试验组患儿肺泡灌洗液出现MP-DNA高拷贝(>106copies/ml)的比例较高,差异有统计学意义(P<0.05)。结论血清总IgE水平升高对RMPP患儿早期识别具有一定的临床意义,RMPP患儿IgE水平升高可成为重症肺炎支原体肺炎的预警因素之一。

Objective To explore the correlation between serum total IgE level and clinical features in children with refractory Mycoplasma pneumoniae pneumonia（ RMPP） and the significance for early recognition of RMPP children. Methods Sixty children diagnosed as RMPP definitely in the hospital from January to October in 2016 were selected,then serum IgE levels were detected,all the children were divided into high IgE level group（ experimental group,40 children） and normal IgE level group（ control group,20 children） according to serum IgE levels. The clinical manifestions,laboratory indexes,imaging characteristics,and bronchoscopic results were compared between the two groups. Results Compared with control group,the proportions of children with transient wheezing and serum C-reactive protein（ CRP） level〉40 mg/L,multiple pulmonary lobes lesions displayed by imaging examination,and pleural effusion in experimental group were higher,there were statistically significant differences（ P〈0. 05）; the proportion of high MP-DNA（ 〉10^6copies/ml） in bronchoalveolar lavage fluid in experimental group was statistically significantly higher than that in control group（ P〈0. 05）. Conclusion The increase of serum total IgE level in children has a certain significance for early diagnosis of RMPP,which may be a predictive factor of severe Mycoplasma pneumoniae pneumonia.