肺炎支原体肺炎患儿血清及肺泡灌洗液MIF水平与气道黏液栓的关系探讨

Study on the Relationship Between the MIF levels of Serum and Bronchoalveolar Lavage Fluid and Airway Mucus Plug in Children with Mycoplasma Pneumoniae Pneumonia

目的 探讨巨噬细胞移动抑制因子(MIF)在肺炎支原体肺炎(MPP)气道黏液栓形成中的表达水平及意义。方法 收集2019年6月-2021月4月佛山市妇幼保健院儿科住院行纤维支气管镜肺泡灌洗术的45例MPP患儿,根据纤维支气管镜纤维管镜下有无黏液栓堵塞呼吸道将MPP患儿分为MPP黏液栓组(20例)和MPP非黏液栓组(25例),另收集同期因急性支气管异物行纤支镜检查的20例支气管异物患儿作为对照组。采用ELISA法测定患儿血清及肺泡灌洗液MIF水平,并对MPP患儿血清MIF水平与肺泡灌洗液MIF水平进行相关性分析。结果 MPP黏液栓组血清及肺泡灌洗液MIF水平高于MPP非黏液栓组及对照组,差异有统计学意义(P<0.05);MPP非黏液栓组血清及肺泡灌洗液MIF水平均高于对照组,差异有统计学意义(P<0.05);Pearson相关性分析显示,MPP黏液栓组血清MIF水平与肺泡灌洗液MIF水平呈正相关(r=0.675,P<0.05);MPP非黏液栓组血清MIF水平与肺泡灌洗液MIF水平亦呈正相关(r=0.814,P<0.05)。结论 MIF可能参与MPP发病过程,特别是MPP黏液栓的形成,早期检测血清MIF水平对MPP黏液栓形成的判断及治疗决策具有重要的参考价值。

Objective To investigate the expression level and significance of macrophage migration inhibitory factor(MIF) in airway mucus plug formation of mycoplasma pneumoniae pneumonia(MPP).Methods From June 2019 to April 2021,45 children with MPP who underwent bronchofibroscopic alveolar lavage in the Department of Pediatrics,Foshan Women and Child Health Hospital were enrolled.According to the presence or absence of mucus plugs in the respiratory tract under fiberoptic bronchoscopy,MPP children were divided into a MPP mucus plug group(20 cases) and a MPP non-mucus plug group(25 cases).Another 20 children with bronchial foreign bodies who underwent bronchoscopy due to acute bronchial foreign bodies were collected as a control group.The levels of MIF in serum and alveolar lavage fluid were measured by ELISA,and the correlation between serum MIF level and alveolar lavage fluid MIF level in MPP children was analyzed.Results The levels of MIF in serum and bronchoalveolar lavage fluid in MPP mucus plug group were higher than those in MPP non-mucus plug group and control group,and the differences were statistically significant(P <0.05).The levels of MIF in serum and bronchoalveolar lavage fluid in MPP non-mucinous embolus group were higher than those in control group(P<0.05).Pearson correlation analysis showed that serum MIF level was positively correlated with bronchoalveolar lavage fluid MIF level in MPP mucus plug group(r =0.675,P <0.05);there was also a positive correlation between serum MIF level and bronchoalveolar lavage fluid MIF level in MPP non-mucus embolus group(r=0.814,P<0.05).Conclusion MIF may be involved in the pathogenesis of MPP,especially the formation of MPP mucus plug.Early detection of serum MIF level has important reference value for the judgment and treatment decision of MPP mucus plug formation.