伴特应质的肺炎支原体肺炎患儿临床特点及相关细胞因子水平变化

Clinical characteristics and changes of cytokines in children with Mycoplasma pneumoniae pneumonia with atopy

目的探讨合并有特应质的肺炎支原体肺炎患儿临床特点及自身的特应质对疾病严重程度和细胞因子的影响。方法选取2018年9月至2020年8月上海交通大学医学院附属仁济医院儿科住院的肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿247例。根据有无特应质分为特应质组和非特应质组,同时根据难治性支原体肺炎(refractory mycoplasma pneumoniae pneumonia,RMPP)诊断标准分为RMPP组和普通型支原体肺炎(general mycoplasma pneumoniae pneumonia,GMPP)组,总结并分析各组临床表现、实验室指标和影像学特点。结果(1)特应质组大环内酯类药物治疗时间、吸氧人数、住院天数高于非特应质组,特应质组中出现重症的人数及胸腔积液的比例高于非特应质组(8.6%v 1.2%),差异有统计学意义(P<0.05);(2)特应质组中血清IL-6、IL-8水平明显高于非特应质组;在RMPP中,伴特应质者药物治疗时间、氧需求及血清IL-6、IL-8水平也更高,差异有统计学意义(P<0.05)。结论伴特应质的MPP患儿病情更重,氧需求及治疗时间更长,血清IL-6、IL-8在特应质者中明显升高,可作为提示病情严重度的预测指标。

Objective To investigate the clinical characteristics of children with atopic Mycoplasma pneumoniae pneumonia(MPP)and the influence of their atopic characteristics on the severity of disease and cytokines.Methods A total of 247 pediatric patients with MPP treated in the Affiliated Renji Hospital of Shanghai Jiao Tong University School of Medicine from September 2018 to August 2020 were enrolled.According to the presence or absence of atopy,they were divided into the atopic group and the non-atopic group.At the same time,according to the diagnostic criteria of refractory Mycoplasma pneumoniae pneumonia(RMPP),they were divided into the RMPP group and the general Mycoplasma pneumoniae pneumonia(GMPP)group.The clinical manifestations,laboratory indicators,and imaging characteristics of each group were summarized and analyzed.Results(1)The duration of macrolide treatment,the number of oxygen intake,and the length of hospitalization in the atopic group were higher than those in the non-atopic group,and the number of severe cases and the proportion of pleural effusion in the atopic group were higher than those in the non-atopic group(8.6%vs 1.2%),with statistical significance(P<0.05).(2)The levels of serum IL-6 and IL-8 in the atopic group were significantly higher than those in the non-atopic group;In the RMPP group,the duration of drug treatment,oxygen demand,and serum IL-6 and IL-8 levels were also higher in patients with atopic substance,with statistical significance(P<0.05).Conclusion MPP children with atopy have more severe disease,longer oxygen demand and treatment time,and serum IL-6,and IL-8 are significantly increased in children with atopy,which can be used as a predictor of disease severity.