儿童肺炎支原体肺炎与呼出气一氧化氮的相关性

The Correlation between Exhaled Nitric Oxide and Mycoplasma Pneumoniae Pneumonia in Children

目的研究肺炎支原体肺炎(MPP)患儿呼出气一氧化氮(FeNO)水平及其与支气管肺泡灌洗液(BALF)菌量高低的相关性.方法选择2016年1月至2016年11月于昆明医科大学附属儿童医院住院的42例MPP患儿,选取50例健康同龄儿童作对照组,对比2组儿童FeNO测定值;采用实时荧光定量PCR(RT-PCR)法检测MPP患儿BALF中肺炎支原体的DNA定量(MP-DNA),将其分为低菌量组(MP-DNA定量≤106copies/m L)及高菌量组(MP-DNA定量>106 copies/m L),对比不同菌量组的FeNO测值;同时,根据临床将MPP患儿分为普通MPP组及难治性肺炎支原体肺炎(RMPP)组,对其FeNO测值进行对比.结果 MPP组FeNO水平[(27.48±5.34)bbp]显著高于健康对照组[(14.24±4.21)bbp],差异有统计学意义(P<0.05);高菌量组FeNO水平[(27.33±6.20)bbp]与低菌量组[(27.58±4.74)bbp]相当,差异无统计学意义(P>0.05);RMPP组FeNO水平[(29.88±4.51)bbp]高于普通MPP组[(26.00±5.35)bbp].结论肺炎支原体感染可引起FeNO水平增高,但其与所感染肺炎支原体菌量高低之间不存在有相关性;与普通MPP相比,RMPP对患儿小气道的损伤可能更突出.

Objective To observe the correlation between the exhaled nitric oxide（FeNO ） and mycoplasmaload in bronchialveolar lavage fluid （BALF ） in children with Mycoplasma pneumoniae pneumonia（MPP ） .Methods 42 inpatients in affiliated children＇s hospital of kunming medical university were enrolled from January toNovember in 2016,and 50 healthy children were selected as control group. Then the value of FeNO were comparedbetween two groups. MP DNA in BALF was detected quantitatively by fluorescent real-time PCR. Children with MPPwere divided into two groups of low MP-DNA load group and high MP-DNA load group according to the copies of MPDNA in BALF less than or equal to106 copies/mL or not. The value of FeNO were compared between groups withdifferent copies of MP DNA. We also compared the level of FeNO between normal MPP group and refractoryMycoplasma pneumonia pneumonia（RMPP ） group. Results The level of FeNO from the patients with MPP[（27.48±5.34） bbp]was significantly higher than that of control group[（14.24±4.21） bbp].The level of FeNObetween the low MP-DNA load group[（27.58±4.74） bbp] and the high MP-DNA load group[（27.33±6.20） bbp]had no statistical significance. The level of FeNO from the patients with RMPP[（29.88±4.51） bbp]was higher thanthat of normal MPP group[（26.00±5.35） bbp]. Conclusion MP infection increase the production of FeNO, and it demonstrates that there is no relationship between the value of FeNO with the MP-DNA load. Compared withnormal MPP,the damage to the small airway maybe more prominent in RMPP.