儿童支气管哮喘合并肺炎支原体感染病情的影响因素

Influencing factors of disease development in children with bronchial asthma complicated with Mycoplasma pneumoniae infection

目的探究外周血CD25、γ-干扰素(IFN-γ)、白细胞介素-5(IL-5)、25羟维生素D3[25(OH)D3]、嗜酸性粒细胞阳离子蛋白(ECP)表达水平与支气管哮喘合并肺炎支原体感染患儿病情发展的相关性。方法回顾性分析2019年1月-2020年1月绍兴市中心医院收治的120例支气管哮喘合并肺炎支原体感染患儿的临床资料,根据患儿疾病发展情况,将其分为轻度组(n=40)、中度组(n=52)和重度组(n=28),另选同期医院收治的30例支气管哮喘、未合并肺炎支原体感染患儿为非感染组(n=30),30名健康儿童为健康对照组(n=30)。对各组患儿的外周血CD25、IFN-γ、IL-5、25-(OH)D3、ECP表达水平进行比较,并分析其表达水平对支气管哮喘合并肺炎支原体感染患儿病情发展的相关性。结果重度组患儿外周血CD25、IL-5、ECP分别为(16.83±5.18)%、(166.54±15.24)pg/ml、(17.52±1.56)μg/L高于轻度组和中度组,且中度组患儿外周血CD25、IL-5、ECP水平明显高于轻度组(P<0.05)。重度组患儿外周血IFN-γ、25-(OH)D3分别为(15.24±3.64)pg/ml、(15.41±5.27)ng/ml低于轻度组和中度组,且中度组患儿外周血IFN-γ、25-(OH)D3低于轻度组(P<0.05)。外周血CD25、IFN-γ、IL-5、25-(OH)D3、ECP表达水平是影响支气管哮喘合并肺炎支原体感染患儿病情发展的影响因素(P<0.05)。外周血CD25、IL-5、ECP与支气管哮喘合并肺炎支原体感染患儿病情发展呈正相关性(P<0.05)。外周血IFN-γ、25-(OH)D3表达水平与支气管哮喘合并肺炎支原体感染患儿病情发展呈负相关性(P<0.05)。结论外周血CD25、IFN-γ、IL-5、25-(OH)D3、ECP是影响支气管哮喘合并肺炎支原体感染患儿病情发展的独立危险因素,且CD25、IL-5、ECP表达水平与病情发展呈正相关性,IFN-γ、25-(OH)D3表达水平与病情发展呈负相关性。

OBJECTIVE To explore the correlation between the expression levels of CD25,interferon-γ(IFN-γ),interleukin-5(IL-5),25 hydroxyvitamin D3[25(OH)D3]and eosinophilic cationic protein(ECP)in peripheral blood and the disease development of children with bronchial asthma complicated with Mycoplasma pneumoniae infection.METHODS The clinical data of 120 children with bronchial asthma complicated with M.pneumoniae infection admitted to shaoxing center hospital from Jan.2019 to Jan.2020 were retrospectively analyzed,and divided into mild group(n=40),moderate group(n=52)and severe group(n=28)according to the disease development of children.Another 30 cases of bronchial asthma without M.pneumoniae infection admitted to the hospital during the same period were selected as the non-infection group(n=30),30 cases of healthy children were selected as healthy controls group(n=30).The expression levels of CD25,IFN-γ,IL-5,25-(OH)D3 and ECP in the peripheral blood of children in each group were compared,and the correlation between the expression levels of CD25,IFN-γ,IL-5,25-(OH)D3 and ECP in the peripheral blood of children with bronchial asthma complicated with M.pneumoniae infection and the disease development was analyzed.RESULTS The levels of CD25,IL-5 and ECP in peripheral blood in severe group were 16.83±5.18%,166.54±15.24 pg/ml,and 17.52±1.56μg/L,respectively,significantly higher than those in mild group(respectivley)and moderate group(respectively).The levels of CD25,IL-5 and ECP in peripheral blood in the moderate group were significantly higher than those in the mild group(P<0.05).The levels of peripheral blood IFN-γand 25-(OH)D3 in the severe group were 15.24±3.64 pg/ml and 15.41±5.27 ng/ml,respectively,significantly lower than those in the mild group(respectively)and the moderate group(respectively),and the levels of peripheral blood IFN-γand 25-(OH)D3 of children in the moderate group were significantly lower than those in the mild group(P<0.05).The expression levels of CD25,IFN-γ,IL-5,25-(OH)D3 and ECP in peripheral blood were the influencing factors for the disease development of children with bronchial asthma complicated with M.pneumoniae infection(P<0.05).There was a positive correlation between CD25,IL-5 and ECP in the peripheral blood and the disease development of children with bronchial asthma complicated with M.pneumoniae infection(P<0.05).The expression levels of IFN-γand 25-(OH)D3 in peripheral blood were negatively correlated with the disease development of children with bronchial asthma complicated with M.pneumoniae infection(P<0.05).CONCLUSION Peripheral blood CD25,IFN-γ,IL-5,25-(OH)D3 and ECP were independent risk factors affecting the development of children with bronchial asthma and M.pneumoniae infection,and the expression levels of CD25,IL-5 and ECP were positively correlated with the development of the disease,while the expression levels of IFN-γand 25-(OH)D3 were negatively correlated with the development of the disease.