婴幼儿重度社区获得性肺炎免疫应答状态分析

Analysis of immune response status in infants and children with severe community-acquired pneumonia

目的观察分析婴幼儿重度社区获得性肺炎免疫应答状态。方法选取120例婴幼儿重度社区获得性肺炎患儿,按照年龄分为A组(0~3个月)、B组(4~6个月)、C组(7个月~1岁)、D组(1~3岁),每组30例;另选取同期普通肺炎患儿30例作为对照组。收集所有患儿的临床资料,记录并分析比较五组患儿血常规指标、C反应蛋白、降钙素原、体液免疫指标、细胞免疫功能指标。结果A组、B组、C组、D组、对照组患儿的中性粒细胞、淋巴细胞、单核细胞计数及单核细胞比例、C反应蛋白、降钙素原水平呈下降趋势,免疫球蛋白(Ig)G、IgM、IgA、B淋巴细胞计数、T淋巴细胞计数、自然杀伤细胞(NK)细胞水平呈上升趋势,五组患儿中性粒细胞、淋巴细胞、单核细胞计数及单核细胞比例、IgG、IgM、IgA、B淋巴细胞计数、T淋巴细胞计数、NK细胞、C反应蛋白、降钙素原比较差异具有统计学意义(P<0.05)。结论与普通肺炎患儿相比,重度社区获得性肺炎患儿存在免疫功能低下。重度社区获得性肺炎患儿的年龄越小,免疫应答越差,其严重程度与肺炎预后相关;随着患儿年龄的增加,体液免疫与细胞免疫功能提升,预后转归更佳。

Objective To observe and analyze the immune response status in infants and children with severe community-acquired pneumonia.Methods A total of 120 infants and children with severe communityacquired pneumonia were selected and divided into group A(0-3 months),group B(4-6 months),group C(7 months-1 year old),and group D(1-3 years old)according to their ages,with 30 cases in each group;another 30 children with common pneumonia during the same period were selected as the control group.The clinical data of the children was collected,and the blood routine indexes,C-reactive protein,procalcitonin,humoral immunity indexes,and cellular immune function indicators of the five groups were recorded and analyzed for comparison.Results The neutrophil,lymphocyte,monocyte count and monocyte ratio,C-reactive protein,and calcitoninogen levels showed a decreasing trend,and the immunoglobulin(Ig)G,IgM,IgA,B lymphocyte count,T lymphocyte count,and natural killer(NK)cell levels showed an increasing trend in groups A,B,C,D,and control group.The differences in neutrophil,lymphocyte,monocyte counts and monocyte ratios,IgG,IgM,IgA,B lymphocyte counts,T lymphocyte counts,NK cells,C-reactive protein,and calcitoninogen among the five groups were statistically significant(P<0.05).Conclusion Children with severe community-acquired pneumonia are immunocompromised compared with children with common pneumonia.The younger the child with severe community-acquired pneumonia,the poorer the immune response,and its severity is related to the prognosis of pneumonia;as the age of the children increases,the humoral and cellular immune functions improve,and the prognostic outcome is better.