儿童大叶性肺炎免疫功能检测

Detection of Immune Function in Children with Lobular Pneumonia

目的分析儿童大叶性肺炎免疫功能特点及在疾病发病机制中的作用,指导临床诊治。方法选择2014年2月—2017年2月间郑州儿童医院呼吸科病房收治的80例住院大叶性肺炎患儿作为研究对象,纳入病例组,另选择同期门诊进行疫苗接种的小儿50例入组,纳入对照组,病例组按照临床肺部感染评分(CPIS)进行严重程度评价,其中分为轻症组(n=54)、重症组(n=26)两个亚组。入院首日或进行门诊疫苗接种的当日采血进行免疫功能指标检测。结果轻症组、病例组外周血淋巴细胞计数、CD4^+/CD8^+、NK、IL-2、IL-8、IL-10、IgA、IgG、IgM水平差异有统计学意义(P<0.05),病例组合计与对照组外周血淋巴细胞计数、CD4^+/CD8^+、IL-2、IL-8、IL-10、IgA、IgG、IgM水平差异有统计学意义(P<0.05)。病例组免疫功能指标与CPIS评分进行相关性分析,结果显示外周血淋巴细胞计数、CD4^+/CD8^+、NK、IL-2、IL-8、IL-10、IgA、IgG、IgM水平均与CPIS评分存在相关性,其中IL-2、IL-10存在负相关,按照相关性绝对值从高到低前5位分别为NK、IL-2、淋巴细胞计数、IL-8、CD4^+/CD8^+。结论儿童大叶性肺炎发生、进展与免疫功能变化关系密切,免疫功能指标变化越显著,病情越严重,需重视免疫功能的检测,预测重症化风险,对于出现免疫紊乱的患者,有必要进行免疫治疗。

Objective To analyze the characteristics of immune function and its role in pathogenesis of lobar pneumonia in children,and to guide clinical diagnosis and treatment.Methods 80 cases of hospitalized children with lobar pneumonia in Respiratory Ward in the hospital from February,2014 to February,2017 were selected to be included in the case group,and 50 children who were vaccinated at the same time were selected as the control group.In the control group,the severity of the disease was evaluated according to the clinical pulmonary infection score(CPIS).Two subgroups were the mild group(n=54)and the severe group(CPIS>6)(n =26).On the first day of admission or the day of outpatient vaccination,the immune function indexes were detected.Results There were significant differences in peripheral blood lymphocyte count,CD4^+/CD8^+,NK,IL-2,IL-8,IL-10,IgA,IgG and IgM level between the mild group and the case group(P<0.05).There was significant difference in lymphocyte count,CD4^+/CD8^+,IL-2,IL- 8,IL-10,IgA,IgG and IgM level between case group and control group(P<0.05).Correlation analysis of immune function index and CPIS score in case group showed that peripheral blood lymphocyte count ,CD4^+/CD8^+,NK,IL-2,IL-8,IL-10,IgA,IgG and IgM level were correlated with CPIS score,and IL-2 and IL-10 had negative correlation.According to the absolute value of correlation from high to low,the first five positions were NK,IL-2,lymphocyte count,IL-8 and CD4^+/CD8^+.Conclusion There is a close relationship between the development and the changes of immune function in children with lobar pneumonia.The more significant the changes of immune function, the more serious the condition is.It is necessary to pay attention to the detection of immune function and predict the severe disease.For patients with immune disorders,immunotherapy is necessary.