支原体肺炎患儿血清补体、免疫球蛋白含量与炎性应激反应的相关性

The correlation between serum complement and immunoglobulin levels and inflammatory stress response in children with mycoplasma pneumonia

目的探讨支原体肺炎患儿血清补体、免疫球蛋白含量与炎性应激反应指标之间的相关性。方法选择2015年8月—2017年2月期间在海南医学院第二附属医院儿科治疗的支原体肺炎患儿314例,其中按照患儿的疾病严重程度分为重症组(n=73)和轻症组(n=241),选择同时间段内到医院体检的健康儿童作为健康对照组(n=150),对3组儿童的血清补体(C3、C4)、免疫球蛋白(IgM、IgA、IgG)和炎性应激反应介质(sICAM1、scd40l、HMGB1、Cor、MDA)含量、炎性应激分子(LR2、TLR4、CD11b、CD18、MPO、NOX2)表达量进行比较,对全部患儿C3、C4、IgM、IgA、IgG的含量与sICAM1、scd40l、HMGB1、Cor、MDA的浓度及LR2、TLR4、CD11b、CD18、MPO、NOX2的荧光强度相关性进行分析。结果 3组受试者血清C3、C4、IgM、IgA含量均为重症组>轻症组>对照组(P<0.05), IgA水平为重症组<轻症组<对照组(P<0.05),但IgG差异无统计学意义(P>0.05);3组sICAM1、scd401、HMGB1、Cor、MDA水平均为重症组>轻症组>对照组(P<0.05);3组受试者的TLR2、TLR4、CD11b、CD18、MPO、NOX2表达量比较差异均具有统计学意义(P<0.01),均为重症组>轻症组>对照组(P<0.05)。全部患儿的C3、C4、IgM与sICAM1、scd40l、HMGB1、Cor、MDA均呈正相关(C3:r=0.238、0.321、0.257、0.251、0.338,C4:r=0.214、0.351、0.308、0.291、0.314,IgM:r=0.421、0.391、0.445、0.391、0.374,P<0.05),全部患儿的IgA与sICAM1、scd40l、HMGB1、Cor、MDA均呈负相关(r=-0.207、-0.425、-0.507、-0.513、-0.386,P<0.05),全部患儿的C3、C4、IgM与TLR2、TLR4、CD11b、CD18、MPO、,NOX2的荧光强度均呈正相关(C3:r=0.286、0.421、0.413、0.387、0.371、0.391,C4:r=0.228、0.415、0.391、0.317、0.441、0.391、,IgM:r=0.357、0.378、0.492、0.358、0.269、0.462,P均<0.05),全部患儿的IgA与TLR2、TLR4、CD11b、CD18、MPO、NOX2的荧光强度均呈负相关(P均<0.05),IgG与TLR2、TLR4、CD11b、CD18、MPO、NOX2的荧光强度之间无相关性(P>0.05)。结论支原体肺炎患儿体内血清补体、免疫球蛋白含量与病情严重程度之间具有一定关系。异常的血清补体和免疫球蛋白变化结果与患儿炎性反应、应激反应具有明显的相关性。

Objective To explore the correlation between serum complement,immunoglobulin and inflammatory stress response in children with Mycoplasma pneumonia.Methods Three hundred and fourteen children with mycoplasmal pneumonia who were treated by Pediatrics in the Second Affiliated Hospital of Hainan Medical College from August 2015 to February 2017 were selected,including the severe group(n=73)and the mild group according to the severity of the disease.(n=241),select healthy children in the same period to the hospital for healthy examination as a healthy control group(n=150),serum complement(C3,C4),immunoglobulin(IgM,IgA,IgG)for the three groups of children.Compared with the expression levels of inflammatory stress media(sICAM1,scd40l,HMGB1,Cor,MDA)and inflammatory stress molecules(LR2,TLR4,CD11b,CD18,MPO,NOX2),all children C3,C4 The contents of IgM,IgA,and IgG were correlated with the concentrations of sICAM1,scd40l,HMGB1,Cor,MDA,and the fluorescence intensity of LR2,TLR4,CD11b,CD18,MPO,and NOX2.Results The serum levels of C3,C4,IgM and IgA in the three groups were all in the severe group>mild group>control group(P<0.05),and the IgA level was in the severe group<light group<control group(P<0.05),but There was no significant difference in IgG(P>0.05).The levels of sICAM1,scd401,HMGB1,Cor and MDA in the three groups were severe group>mild group>control group(P<0.05);TLR2 and TLR4 of the three groups were observed.The expression differences of CD11b,CD18,MPO and NOX2 were statistically significant(P<0.01),all were in severe group>slight group>control group(P<0.05).C3,C4,IgM were positively correlated with sICAM1,scd40l,HMGB1,Cor,and MDA in all children(C3:r=0.238,r=0.321,r=0.257,r=0.251,r=0.338,C4:r=0.214,r=0.351,r=0.308,r=0.291,r=0.314,IgM:r=0.421,r=0.391,r=0.445,r=0.391,r=0.374,P<0.05),IgA of all children sICAM1,scd40l,HMGB1,Cor,MDA were negatively correlated(r=-0.207,r=-0.425,r=-0.507,r=-0.513,r=-0.386,P<0.05),all children's C3,The fluorescence intensities of C4 and IgM were positively correlated with TLR2,TLR4,CD11b,CD18,MPO,and NOX2(C3:r=0.286,r=0.421,r=0.413,r=0.387,r=0.371,r=0.391,C4:r=0.228,r=0.415,r=0.391,r=0.317,r=0.441,r=0.391,IgM:r=0.357,r=0.378,r=0.492,r=0.358,r=0.269,r=0.462,P<0.05),the fluorescence intensity of IgA and TLR2,TLR4,CD11b,CD18,MPO and NOX2 were negatively correlated(P<0.05),IgG and TLR2,TLR4,CD11b,CD18,MPO,There was no correlation between the fluorescence intensities of NOX2(P>0.05).Conclusion The serum complement and immunoglobulin levels in children with mycoplasma pneumonia were correlated with the severity of the disease.Abnormal changes of serum complement and immunoglobulin were significantly correlated with inflammatory and stress reactions in children.