不同程度肺炎支原体感染大叶性肺炎患儿肺通气功能及相关实验室指标特征

Characteristics of Pulmonary Ventilation Function Related Laboratory Indexes in Children with Lobar Pneumonia Infected by Different Degrees of Mycoplasma Pneumoniae Pneumonia

目的探究不同病变程度肺炎支原体(MP)感染大叶性肺炎患儿肺通气功能及相关实验室指标特征。方法将2019年1月至2023年8月在漯河医学高等专科学校第二附属医院接受治疗的60例MP感染大叶性肺炎患儿纳入本次研究中,根据肺部感染评分对患儿的病情严重程度进行评价,并据此对患儿进行分组:评分在6分及以上的25例患儿纳入重症组,低于6分的35例患儿纳入轻症组,比较两组患儿的肺通气功能情况及C反应蛋白(CRP)、降钙素原(PCT)、25-羟基维生素D[25-(OH)D]水平。结果重症组患者的第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)占预计值百分比(FEV_(1)%pred)、FEV_(1)/FVC、最大呼气流量(PEF)、25-羟基维生素D(25-(OH)D)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平较轻症组降低(P<0.05),重症组患者的CRP、PCT水平高于轻症组(P<0.05),但组间IgM水平差异无统计学意义(P>0.05)。经Spearman相关分析,可知患者的肺通气功能随着病情加重而降低,二者呈负相关,CRP、PCT水平与患者的病情严重程度呈正相关,25-(OH)D与其病情严重程度呈负相关(P<0.05)。结论重症MP感染大叶性肺炎患儿的肺通气功能下降,25-(OH)D、IgA、IgG水平降低,CRP、PCT水平升高。重症组表现出更严重的肺功能受损和炎症反应,该结果对病情变化监测和治疗具有指导意义。

Objective To explore the characteristics of pulmonary ventilation function,respiratory compliance and related laboratory indexes in children with lobar pneumonia infected with different degrees of Mycoplasma pneumoniae(MP)pneumonia.Methods Sixty children with lobular pneumonia infected with MP who received treatment in the Second Affiliated Hospital of Luohe Medical College from January 2019 to August 2023 were included in this study.The severity of the disease of the children was evaluated according to the pulmonary infection score,and the children were divided into the following groups:twenty-five children with scores above grade 6 were included in the severe group,and 35 children with scores below grade 6 were included in the mild group.The pulmonary ventilation function,respiratory compliance,and the levels of C-reactive protein(CRP),procalcitonin(PCT),and 25-hydroxyvitamin D[25-(OH)D]between the two groups were compared.Results In the severe group,forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),predicted forced expiratory percentage in one second(FEV_(1)%pred),FEV_(1)/FVC,peak expiratory flow rate(PEF),25-hydroxyvitamin D[25-(OH)D],immunoglobulin A(IgA),immunoglobulin G(IgG)levels decreased(P<0.05),CRP and PCT levels in the severe group were higher than those in the mild group(P<0.05),However,there was no significant difference in IgM levels between groups(P>0.05).According to Spearman correlation analysis,we showed that the pulmonary ventilation function decreased with the aggravation of the illness,the two were negatively correlated,CRP and PCT levels were positively correlated with the severity of the patient,and 25-(OH)D was negatively correlated with the severity of the condition(P<0.05).Conclusion The pulmonary ventilation function and respiratory compliance of children with lobar pneumonia with severe MP infection were decreased,the levels of 25-(OH)D,IgA and IgG were decreased,and the levels of CRP and PCT were increased.The severe group showed more severe lung function impairment and inflammatory response,and the results have guiding significance for monitoring and treatment of disease changes.