小儿难治性支原体肺炎患儿免疫学水平对预后的影响

Influence of immunological levels on prognosis in children with refractory mycoplasma pneumonia

目的探讨小儿难治性支原体肺炎患儿免疫学水平对预后的影响。方法回顾性选择2021年6月至2022年4月福建省龙岩市第二医院收治的57例小儿难治性支原体肺炎患儿为研究对象,根据治疗预后分为预后良好组(n=46)和预后差组(n=11)。比较两组细胞免疫、体液免疫、白细胞计数(WBC)、C反应蛋白(CRP)水平,采用多因素logistic回归分析小儿难治性支原体肺炎患儿免疫学水平对预后的影响。结果预后良好组CD4^(+)、CD4^(+)/CD8^(+)均高于预后差组,CD8^(+)、免疫球蛋白(Ig)G、IgE、IgA、WBC和CRP均低于预后差组,差异有统计学意义(P<0.05);多因素logistic回归分析结果显示,CD4^(+)(OR=3.582,95%CI=2.482~6.313)、CD4^(+)/CD8^(+)(OR=6.413,95%CI=5.682~8.452)、CD8^(+)(OR=4.083,95%CI=3.235~4.572)、IgG(OR=1.034,95%CI=0.283~4.394)、IgE(OR=1.593,95%CI=1.241~1.786)、IgA(OR=1.246,95%CI=0.987~1.583)、WBC(OR=1.692,95%CI=1.212~1.889)、CRP(OR=1.326,95%CI=1.021~1.984)均为小儿难治性支原体肺炎患儿预后的免疫水平因素(P<0.05)。结论细胞免疫与体液免疫在难治性支原体肺炎患儿中表达异常,能预测患儿治疗预后,可为临床诊疗提供参考依据。

Objective To explore the influence of immunological levels on prognosis in children with refractory mycoplasma pneumonia.Methods A retrospective study was conducted on 57 children with refractory mycoplasma pneumonia admitted to the Second Hospital of Longyan City from June 2021 to April 2022.According to different prognosis,they were divided into the good prognosis group(n=46)and the poor prognosis group(n=11).The cellular immunity,humoral immunity,white blood cells(WBC)and C-reactive protein(CRP)levels of the two groups were compared.Multivariate logistic regression analysis was used to investigate the impact of immunological levels on prognosis in children with refractory mycoplasma pneumonia.Results CD4^(+),CD4^(+)/CD8^(+)in the good prognosis group were higher than those in the poor prognosis group,and CD8^(+),immunoglobulin(Ig)G,IgE,IgA,WBC and CRP were lower than those in the poor prognosis group,with statistical significance(P<0.05).Multivariate logistic regression analysis showed that CD4^(+)(OR=3.582,95%CI=2.482-6.313),CD4^(+)/CD8^(+)(OR=6.413,95%CI=5.682-8.452),CD8^(+)(OR=4.083,95%CI=3.235-4.572),IgG(OR=1.034,95%CI=0.283-4.394),IgE(OR=1.593,95%CI=1.241-1.786),IgA(OR=1.246,95%CI=0.987-1.583),WBC(OR=1.692,95%CI=1.212-1.889),CRP(OR=1.326,95%CI=1.021-1.984)were all immune level factors for prognosis of children with refractory mycoplasma pneumonia(P<0.05).Conclusion Abnormal expression of cellular and humoral immunity in children with refractory mycoplasma pneumonia can predict prognosis and provide reference for clinical diagnosis and treatment.