肺炎支原体感染与小儿支气管哮喘急性发作的关系

Correlation between Mycoplasma pneumonia infection and acute attack of bronchial asthma in children

目的探析小儿支气管哮喘急性发作和肺炎支原体(MP)感染之间的关系。方法将50例支气管哮喘急性期患儿和50例支气管哮喘缓解期患儿作为此次研究的对象,将50例支气管哮喘缓解期患儿纳入到对照组,50例支气管哮喘急性期患儿纳入到试验组,均接受血清学、肺功能、免疫功能等检测。比较两组患儿MP感染率和抗体滴度、肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC]、免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))以及试验组MP阳性、阴性患儿各项指标[嗜酸性粒细胞阳离子蛋白(ECP)、白细胞介素-5(IL-5)、嗜酸性粒细胞(EOS)计数、免疫球蛋白E(IgE)]。结果试验组MP阳性率为72.00%、抗体滴度1∶320占比为83.33%,均高于对照组的34.00%、29.41%(P<0.05);试验组MP阴性率为28.00%、抗体滴度1∶160占比为16.67%,均低于对照组的66.00%、70.59%,差异有统计学意义(P<0.05)。试验组MP阳性患儿ECP、IL-5、EOS计数、IgE分别为(12.49±1.17)μg/L、(3.91±0.16)ng/L、(518.23±36.67)×10^(6)/L、(365.62±78.42)IU/ml,均高于MP阴性患儿的(8.16±1.47)μg/L、(2.41±0.17)ng/L、(402.68±49.62)×106/L、(289.61±44.23)IU/ml,差异有统计学意义(P<0.05)。试验组CD4^(+)、CD4^(+)/CD8^(+)分别为(29.48±2.96)%、(1.28±0.42),均明显低于对照组的(34.41±2.43)%、(1.58±0.52),CD8^(+)(31.59±2.19)%高于对照组的(23.91±1.65)%,差异有统计学意义(P<0.05)。试验组FEV1、FVC、FEV1/FVC分别为(1.48±0.24)L、(2.19±0.23)L、(67.26±6.62)%,均低于对照组的(1.93±0.21)L、(2.44±0.24)L、(79.16±5.17)%,差异有统计学意义(P<0.05)。结论支气管哮喘急性发作患儿多数会伴有MP感染情况,会显著降低患儿的肺功能,引起人体免疫功能紊乱,加重其支气管哮喘症状,因此,MP感染可作为临床诊治小儿支气管哮喘急性发作的重要依据。

Objective To explore the correlation between Mycoplasma pneumonia(MP)infection and acute attack of bronchial asthma in children.Methods 50 children in acute stage of bronchial asthma and 50 children in remission stage of bronchial asthma were selected as the subjects of this study.50 children in remission stage of bronchial asthma were included in the control group,and 50 children in acute stage of bronchial asthma were included in the experimental group,all of whom were subjected to the tests of serology,lung function,immune function.Comparison was made on MP infection rates,antibody titers,lung function[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and FEV1/FVC],immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))between the two groups,as well as various indicators[eosinophil cationic protein(ECP),interleukin-5(IL-5),eosinophil(EOS)count,immunoglobulin E(IgE)]of MP positive and negative children in the experimental group.Results The MP positive rate in the experimental group was 72.00%and the percentage of antibody titer 1∶320 was 83.33%,which were higher than 34.00%and 29.41%in the control group;the MP negative rate in the experimental group was 28.00%and the percentage of antibody titer 1∶160 was 16.67%,which were lower than 66.00%and 70.59%in the control group.The difference was statistically significant(P<0.05).In the experimental group,ECP,IL-5,EOS count and IgE of MP-positive children were(12.49±1.17)μg/L,(3.91±0.16)ng/L,(518.23±36.67)×10^(6)/L and(365.62±78.42)IU/ml,which were higher than(8.16±1.47)μg/L,(2.41±0.17)ng/L,(402.68±49.62)×10^(6)/L and(289.61±44.23)IU/ml of MP-negative children,and the difference was statistically significant(P<0.05).CD4^(+)and CD4^(+)/CD8^(+)in the experimental group were(29.48±2.96)%and(1.28±0.42),which were significantly lower than(34.41±2.43)%and(1.58±0.52)in the control group;the experimental group had CD8^(+)of(31.59±2.19)%,which was higher than(23.91±1.65)%in the control group;the difference was statistically significant(P<0.05).FEV1,FVC and FEV1/FVC in the experimental group were(1.48±0.24)L,(2.19±0.23)L and(67.26±6.62)%,which were lower than(1.93±0.21)L,(2.44±0.24)L and(79.16±5.17)%in the control group.The difference was statistically significant(P<0.05).Conclusion Most of the children with acute attacks of bronchial asthma are accompanied by MP infection,which significantly reduces the lung function of the children,causes immune disorders,and exacerbates the symptoms of bronchial asthma,so MP infection can be used as an important basis for the clinical diagnosis and treatment of acute attacks of bronchial asthma in children.