肺泡灌洗液IL-8、IL-10、INF-γ水平与儿童难治性支原体肺炎及其治疗效果的关系研究

Study on the relationship between levels of IL-8, IL-10 and INF-γ in bronchoalveolar lavage fluid and refractory mycoplasma pneumonia in children and its treatment effects

目的探究肺泡灌洗液(BALF)白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、干扰素-γ(INF-γ)水平与儿童难治性支原体肺炎(RMPP)及其治疗效果的关系。方法回顾性分析我院收治的45例RMPP患儿临床资料纳入RMPP组,根据疗法与疗效不同分为A组(单纯肺泡灌洗治疗有效,n=27)、B组(肺泡灌洗治疗效果欠佳而加用激素治疗后有效,n=13)与C组(肺泡灌洗联合激素治疗无效,n=5)三个亚组,另将同时期接受支气管肺泡灌洗的45例普通支原体肺炎患儿床资料纳入普通组。分析两组及各亚组间患儿BALF中IL-8、IL-10、INF-γ水平差异,并采用Logistic多元回归分析模型分析其与疗效的关系。结果治疗前,RMPP组IL-8、INF-γ水平均明显高于普通组,而IL-10水平则明显低于普通组(P<0.05)。治疗后,三组IL-8、INF-γ水平A组<B组<C组,而IL-10水平A组>B组>C组,组间比较均有统计学意义(P<0.05)。Logistic多元回归分析显示,RMPP患儿BALF中IL-8、INF-γ水平与治疗效果呈负相关,而IL-10水平与治疗效果呈正相关(P<0.05)。结论肺泡灌洗液IL-8、IL-10、INF-γ水平与RMPP及其治疗效果密切相关,可为临床诊疗及预后评估提供一定参考依据。

Obejctive To explore the relationship between levels of interleukin-8（IL-8）,interleukin-10（IL-10） and interferon-γ（INF-γ） in bronchoalveolar lavage fluid（BALF） and refractory mycoplasma pneumonia（RMPP） in children and its treatment effects. Methods The clinical data of 45 RMPP children（RMPP group） admitted to our hospital were retrospectively analyzed.The patients were divided into group A（cured effectively for pure bronchoalveolar lavage,n=27）,group B（not good enough effect for bronchoalveolar lavage but markedly effective for combination of hormone,n=13）,and group C（invalid for bronchoalveolar lavage and hormone,n=5） three subgroups.And other 45 children with common mycoplasma pneumonia treated with bronchoalveolar lavage simultaneously were included in the common group.The levels of IL-8,IL-10 and INF-γ in BALF between the two group and among subgroups were analyzed,and Logistic multivariate regression analysis model was used to analyze their relationship with the treatment effect. Results Before treatment,the levels of IL-8 and INF-γ in RMPP group were significantly higher than those in common group while the level of L-10 in RMPP group was significantly lower than that in common group（P 0.05）.After treatment, the levels of IL-8 and INF-γ in three groups showed that group A group B group C,while the level of IL-10 showed that group A group B group C,there were statistical significance in the comparison between groups（P 0.05）.Logistic multivariate regression analysis showed that the levels of IL-8 and INF-γ in BALF of RMPP children were negatively correlated with treatment effects while the level of IL-10 was positively correlated with treatment effects（P 0.05）. Conclusion The levels of IL-8, IL-10 and INF-γ in BALF are closely related to RMPP and treatment effects,which may provide some references for clinical diagnosis and prognosis evaluation.