肺炎支原体肺炎患儿联合检测外周血T细胞免疫指标、超敏C-反应蛋白及降钙素原水平的临床诊治意义

Clinical significance of combined detection of peripheral blood T cell immune index, hs-CRP and PCT levels in children with Mycoplasma pneumoniae pneumonia

目的:探讨肺炎支原体肺炎患儿联合检测外周血T细胞免疫指标、超敏C-反应蛋白(hs-CRP)及降钙素原(PCT)水平的临床诊治意义。方法:选取肺炎支原体肺炎患儿72例作为观察组,根据其影像学表现分为大叶性肺炎组(32例)和支气管肺炎组(40例)。同期选取正常体检小儿50例作为对照组。比较三组免疫球蛋白(Ig)异常率、T细胞亚群水平以及血清hs-CRP、PCT水平。结果:大叶性肺炎组、支气管肺炎组的IgG、IgM、IgE异常率均明显高于对照组,差异有统计学意义(P<0.05),IgA异常率比较,差异无统计学意义(P>0.05),大叶性肺炎组IgG异常率明显高于支气管肺炎组,差异有统计学意义(均P<0.05),IgM、IgE、IgA异常率比较,差异无统计学意义(P>0.05);大叶性肺炎组、支气管肺炎组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显低于对照组,CD8^(+)水平明显高于对照组,差异有统计学意义(P<0.05),大叶性肺炎组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显低于支气管肺炎组,CD8^(+)水平明显高于支气管肺炎组,差异有统计学意义(P<0.05);大叶性肺炎组、支气管肺炎组的血清hs-CRP、PCT水平明显高于对照组,大叶性肺炎组明显高于支气管肺炎组,差异有统计学意义(P<0.05)。结论:外周血T细胞免疫指标、hs-CRP及PCT水平联合检测肺炎支原体肺炎患儿效果显著,可用来分辨大叶性肺炎和支气管肺炎,可为临床诊治提供指导。

Objective To explore the clinical significance of combined detection of peripheral blood T cell immune index,C-reactive protein(hs-CRP)and procalcitonin(PCT)levels in children with Mycoplasma pneumoniae pneumonia.Method 72 children with Mycoplasma pneumoniae pneumonia were selected as the observation group.According to their imaging manifestations,they were divided into lobar pneumonia group(32 cases)and bronchial pneumonia group(40 cases).At the same time,50 children with normal physical examination were selected as the control group.The abnormal rate of immunoglobulin(Ig),the level of T cell subsets,serum hs-CRP and PCT were compared among the three groups.Results The abnormal rates of IgG,IgM and IgE in lobar pneumonia group and bronchopneumonia group were significantly higher than those in control group(P<0.05),and there was no significant difference in the abnormal rate of IgA(P>0.05).The abnormal rate of IgG in lobar pneumonia group was significantly higher than that in bronchopneumonia group(P<0.05).There was no significant difference in the abnormal rate of IgM,IgE,IgA(P>0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in lobar pneumonia group and bronchopneumonia group were significantly lower than those in control group,and the level of CD8^(+)was significantly higher than that in control group(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in lobar pneumonia group were significantly lower than those in bronchopneumonia group,and the level of CD8^(+)was significantly higher than that in bronchopneumonia group(P<0.05).The serum levels of hs-CRP and PCT in lobar pneumonia group and bronchopneumonia group were significantly higher than those in control group,and those in lobar pneumonia group were significantly higher than those in bronchopneumonia group(P<0.05).Conclusion The combined detection of peripheral blood T cell immune indexes,hs-CRP and PCT levels in children with Mycoplasma pneumoniae pneumonia is effective.It can be used to distinguish lobar pneumonia and bronchial pneumonia,and can provide guidance for clinical diagnosis and treatment.