小儿支原体肺炎血Th17/Treg细胞失衡与心肌损害发生的相关性

Correlation between imbalance of blood Th17/Treg cells and myocardial damage in children with mycoplasma pneumonia

目的探讨小儿支原体肺炎血Th17/调节性T细胞(Treg)失衡与心肌损害发生的相关性。方法选择2020年3月—2022年3月于邢台市人民医院就诊的支原体肺炎患儿137例作为观察对象,通过肌酸激酶同工酶(CK-MB)水平,影像学检查及心电图表现等判定心肌损害,并根据是否发生心肌损害将患儿分为心肌损害组和无心肌损害组。另选择同期健康体检儿童96例作为对照组。采用流式细胞仪测定Th17细胞和Treg细胞占CD4^(+)T细胞比例;采用全自动生化分析仪测定乳酸脱氢酶(LDH)、肌酸激酶(CK)和CK-MB水平。比较各组Th17细胞占CD4^(+)T细胞比例、Treg细胞占CD4^(+)T细胞比例、Th17/Treg和心肌酶水平变化。采用Pearson相关性分析Th17/Treg与心肌酶相关性。结果137例支原体肺炎患儿中,发生心肌损害72例(52.55%)。心肌损害组血清LDH、CK和CK-MB水平高于无心肌损害组和对照组,且无心肌损害组血清LDH、CK和CK-MB水平高于对照组(P<0.05)。心肌损害组Th17细胞占CD4^(+)T细胞比例和Th17/Treg高于无心肌损害组和对照组,且Treg细胞占CD4^(+)T细胞比例低于无心肌损害组和对照组(P<0.05)。Pearson相关性分析结果显示,Th17/Treg与LDH、CK和CK-MB呈正相关(P<0.05)。结论小儿支原体肺炎并发心肌损害患儿心肌酶谱LDH、CK和CK-MB水平明显升高,Th17/Treg细胞比例失衡,且Th17/Treg与LDH、CK和CK-MB呈正相关。

Objective To investigate the relationship between blood Th17/regulatory T cell(Treg)imbalance and myocardial damage in children with mycoplasma pneumonia.Methods The 137 children with mycoplasma pneumonia in Xingtai People′s hospital from March 2020 to March 2022 were selected as the research objects.In addition,96 children who underwent physical examination in the hospital from March 2020 to March 2022 were selected as the control group.Myocardial damage was determined by creatine kinase isoenzyme(CK-MB)level,imaging examination and ECG.The proportion of Th17 cells and Treg cells in CD4^(+)T cells was measured by flow cytometry.The levels of lactate dehydrogenase(LDH),creatine kinase(CK)and CK-MB were measured by automatic biochemical analyzer.The occurrence of myocardial damage in children with mycoplasma pneumonia,Th17 cells to CD4^(+)T cells ratio,Treg cells to CD4^(+)T cells ratio,the levels of Th17/Treg and myocardial enzymes were observed.The correlation between Th17/Treg and myocardial enzymes were analyzed.Results Among 137 children with mycoplasma pneumonia,72 cases had myocardial damage,accounting for 52.55%.The levels of serum LDH,CK and CK-MB in myocardial damage group were higher than non-myocardial damage group and control group,and the levels of serum LDH,CK and CK-MB in non-myocardial damage group were higher than control group(P<0.05).The proportion of Th17 cells in CD4^(+)T cells and Th17/Treg in myocardial damage group were higher than non-cardiac muscle damage group and control group,and the proportion of Treg cells in CD4^(+)T cells was lower than non-cardiac muscle damage group and control group(P<0.05).Pearson correlation analysis showed that Th17/Treg was linearly and positively correlated with LDH,CK and CK-MB.Conclusion The levels of myocardial enzymes LDH,CK and CK-MB in children with mycoplasma pneumonia complicated with myocardial damage are significantly increased,and the ratio of Th17/Treg cells is unbalanced,which is linearly positively correlated with LDH,CK and CK-MB.