小儿支气管肺炎免疫功能变化及意义

Abstract

目的：探讨小儿支气管肺炎及肺炎支原体感染后免疫功能的变化。方法：选取肺炎支原体肺炎患儿56例(MPP组)和普通肺炎患儿50例(普通组)，同时选取同期健康体检儿童50例为对照组，应用流式细胞术测定患儿外周血Ｔ淋巴细胞亚群；应用ELISA法测定患儿外周血免疫球蛋白。结果MMP组CD3+、CD4+、CD4+/CD8+明显降低于普通组，两组均低于对照组，三组之间比较差异有显著性。支原体肺炎组IgA显著低于普通肺炎组和对照组，IgM和IgG在三组之间无显著性差异。结论：小儿支气管肺炎患者免疫功能处于相对低下状态，以支原体肺炎更加明显，并且恢复相对缓较慢；MP的发病机制可能与免疫复合物介导的免疫损伤相关。 Objective: To investigate the changes of cellular immune function in children with pneumonia and Mycoplasma pneumoniae pneumonia (MPP). Methods: 56 patients with MPP and 50 patients with pneumonia were enrolled in this study, and 50 healthy children who had physical examination during the same period were enrolled as the control group. T lymphocyte subgroups were determined by flow cytometry. The levels of serum immunoglobulin (IgG, IgA and IgM) were evaluated by ELISA. Results: The percentage of CD3+, CD4+ lymphocytes and the ratio of CD4+/CD8+ lymphocytes in MPP group were significantly lower than that of the pneumonia group, and both were significantly lower than those in the control group (P < 0.05). The level of IgA in the both of acute phase and recover phase of MPP group was significantly lower than that of pneumonia group and control group. There was no significant difference in the levels of serum immunoglobulin (IgG and IgM) in the three groups. Conclusions: The immune function of the children with pneumonia is depressed and relatively low, especially in MMP, which recovered lower. Immunocomplex-mediated immunologic injury may play a role in the pathogenesis of MPP.