白细胞介素-6、-8、-1β在不同肺炎患儿血清及支气管肺泡灌洗液中的变化及临床意义

Changes and Clinical Significance of Interleukin in Serum and Bronchoalveolar Lavage Fluid of Children with Different Pneumonia

目的:探讨白细胞介素-6(IL-6)、IL-8、IL-1β在不同肺炎患儿血清和支气管肺泡灌洗液(BALF)中的变化及临床意义。方法:选取2018年上海市某儿童专科医院呼吸科收治的肺炎支原体肺炎患儿50例为支原体组,肺炎链球菌性肺炎患儿42例为细菌组,支气管异物患儿20例为对照组。采用化学发光法检测三组患儿血清与BALF中IL-6、IL-8、IL-1β含量,同时采集和检测三组患儿血C-反应蛋白(CRP)、降钙素原(PCT)、白细胞数及中性粒细胞数比值。结果:细菌性肺炎患儿白细胞计数、CRP、PCT较支原体肺炎组和对照组升高,差异有统计学意义(P<0.05),支原体组和细菌组中性细胞数比值比较差异无统计学意义(P>0.05);细菌性肺炎患儿血清IL-6较支原体肺炎组和对照组高,差异有统计学意义(P<0.01),支原体组和细菌组血清IL-8、IL-1β水平比较差异无统计学意义(P>0.05);支原体组BALF中IL-8、IL-1β水平高于细菌性组和对照组(P<0.01);支原体组和细菌组BALF中IL-6水平均升高,差异无统计学意义(P>0.05)。结论:白细胞、CRP、PCT和血清IL-6升高可帮助诊断细菌性肺炎。支原体肺炎患儿BALF中IL-8和IL-1β水平明显升高,IL-8和IL-1β可能参与了支原体肺炎的发生发展,在疾病加重的过程中起重要作用。

Objective:To investigate the changes and clinical significance of interleukin-6(IL-6),IL-8 and IL-1βin serum and bronchoalveolar lavage fluid(BALF)of children with different pneumonia.Methods:A total of 50 children with Mycoplasma pneumoniae pneumonia admitted into respiratory department of a Children’s Hospital of Shanghai in 2018 were extracted as the Mycoplasma group,42 children with Streptococcus pneumoniae pneumonia were extracted as the bacteria group,and 20 children with abnormal objects in bronchus were extracted as the control group.Levels of IL-6,IL-8 and IL-1βin serum and BALF of three groups were detected by chemiluminescent immunoassay.C-reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC)count and neutrophil count ratio were collected and measured.Results:WBC count,CRP and PCT of children with bacterial pneumonia were higher than those of the Mycoplasma pneumonia group and the control group(P<0.05).The difference of the neutrophil count ratio in the Mycoplasma group and the bacteria group was not statistically significant(P>0.05).The serum levels of IL-6 of children with bacterial pneumonia was higher than that of the Mycoplasma group and the control group,and the difference was statistically significant(P<0.01).The differences in serum levels of IL-8 and IL-1βbetween the Mycoplasma group and the bacteria group were not statistically significant(P>0.05).The serum levels of IL-8 and IL-1βin BALF of Mycoplasma group were significantly higher than those of the bacteria group and the control group(P<0.01).The serum levels of IL-6 in BALF of the Mycoplasma group and the bacteria group were elevated,and the difference was not statistically significant(P>0.05).Conclusion:Elevated WBC,CRP,PCT,and serum IL-6 can help to diagnose the bacterial pneumonia.The serum levels of IL-8 and IL-1βare significantly elevated in BALF in children with Mycoplasma pneumoniae pneumonia,and IL-8 and IL-1βmay be involved in the development of Mycoplasma pneumoniae pneumonia and play an important role in the exacerbation of the disease.