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目的探讨新生儿感染性肺炎白细胞介素_18(IL_18)和γ_干扰素 (IFN_γ)与免疫球蛋白 (IgG、IgA和IgM )的关系。方法采用免疫酶法 (ELISA)和速率散射比浊法检测111例感染性肺炎患儿血清IL_18、IFN_γ、IgG、IgA和IgM含量。以CRP≥20mg/L作为诊断细菌感染的界限值 ,结合其他临床资料 ,将肺炎患儿分为4组进行分析。结果①肺炎组111份血清中 ,8型常见病毒及支原体特异性IgM阳性40份 (36.0 % ) ,对照组30份血清均阴性 ;病毒及支原体感染23例 (20.7% ) ,细菌感染45例 (40.6 % ) ,病毒及支原体与细菌混合感染17例 (15.3% ) ,其他不明病原感染26例 (23.4% )。②肺炎组IgA、IgM含量>对照组 (P<0.05)。其中 ,病毒及支原体感染组IgA含量>其他不明病原感染组和对照组 (P<0.05) ;细菌感染组IgM含量>对照组 (P<0.05)。肺炎各组IgG、IL_18和IFN_γ含量与对照组比较 ,差异无统计学意义 (P>0.05)。③对照组IgM与IFN_γ呈正相关 (P<0.01)。病毒及支原体感染组IgA和IgM分别与IFN_γ呈正相关 (P<0.01) ;IgA和IgM分别与IL_18呈正相关 (P<0.05) ;IFN_γ与IL_18呈正相关 (P<0.05)。细菌感染组IgA与IL_18呈正相关 (P<0.01)。结论新生儿发生病毒或细菌感染时 ,体内抗感染免疫和免疫调节的机制不同 ,不同种类免疫球蛋白含量也不相同
Objective To investigate the relationship between interleukin 18 (IFN_ 18) and interferon gamma (IFN_γ) and immunoglobulin (IgG, IgA and IgM) in neonatal pneumonia. Methods The serum levels of IL-18, IFN-γ, IgG, IgA and IgM in 111 children with infectious pneumonia were detected by enzyme-linked immunosorbent assay (ELISA) and rate nephelometry. To CRP ≥ 20mg / L as a diagnostic threshold for bacterial infection, combined with other clinical data, the children with pneumonia were divided into four groups for analysis. Results (1) In the 111 pneumonia group, 40 (36.0%) were positive for type 8 common virus and mycoplasma-specific IgM, 30 were negative for the control group, 23 were viral and mycoplasma (20.7%), 45 were bacterial infection 40.6%), 17 cases (15.3%) were infected by virus and mycoplasma mixed with bacteria, and 26 cases (23.4%) were infected by other unidentified pathogens. ② IgA and IgM levels in pneumonia group> control group (P <0.05). Among them, IgA content in virus and mycoplasma infection> other unknown pathogenic infection group and control group (P <0.05); IgM content in bacterial infection group> control group (P <0.05). The levels of IgG, IL_18 and IFN_γ in pneumonia group were not significantly different from those in control group (P> 0.05). ③ The control group IgM and IFN_γ was positively correlated (P <0.01). The levels of IgA and IgM in virus and mycoplasma were positively correlated with IFN_γ (P <0.01). IgA and IgM were positively correlated with IL_18 (P <0.05). IFN_γ was positively correlated with IL_18 (P <0.05). IgA was positively correlated with IL_18 in bacterial infection (P <0.01). Conclusions In neonates with virus or bacterial infection, the mechanism of anti-infective and immune regulation in vivo is different, and the content of different kinds of immunoglobulins is different