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目的:探讨肺表面活性物质相关蛋白A(surfactant protein-A,SP-A)在肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)中的作用及临床意义。方法:收集2014年1月1日—2015年12月31日在南京医科大学附属儿童医院住院的肺炎患儿共51例:其中MPP患儿41例,分别为MPP组15例,MPP伴肺不张组26例,同时设立同期入院非支原体感染的普通肺炎10例为对照组,采用ELISA法检测各组患儿血清和肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中SP-A含量,逆转录聚合酶链反应方法(RT-PCR)检测血清SP-A m RNA相对表达情况。结果:(1)MPP组、MPP伴肺不张组血清、BALF中SP-A蛋白水平均低于对照组,差异均有统计学意义(P<0.05),但MPP组、MPP伴肺不张组之间差异无统计学意义(P>0.05)。(2)MPP组及MPP伴肺不张组血清SP-A含量及m RNA水平与BALF中SP-A蛋白含量均呈正相关(r=0.42,P=0.01;r=0.41,P=0.04)。(3)MPP伴肺不张组血清、BALF中SP-A含量及血清SP-A m RNA水平与肺复张时间无明显相关性(P值均>0.05)。结论:MPP患儿血清、BALF中SP-A蛋白含量明显下降,MPP中可能存在肺泡Ⅱ型细胞损伤,SP-A的替代治疗或促进SP-A生成的治疗对MPP的恢复将有一定意义。
Objective: To investigate the role of surfactant protein-A (SP-A) in Mycoplasma pneumoniae pneumonia (MPP) and its clinical significance. Methods: A total of 51 children with pneumonia admitted to Children’s Hospital Affiliated to Nanjing Medical University from January 1, 2014 to December 31, 2015 were enrolled. Among them, 41 children were MPP, 15 were MPP, Zhang group of 26 cases, while the establishment of simultaneous admission of non-mycoplasma pneumonia in 10 cases of normal control group, ELISA method was used to detect serum and bronchoalveolar lavage fluid (BALF) SP-A content, reverse transcription The relative expression of SP-A m RNA in serum was detected by polymerase chain reaction (RT-PCR). Results: (1) The levels of SP-A protein in MPP group, MPP group with atelectasis and BALF were significantly lower than those in control group (P <0.05), but MPP group and MPP group with atelectasis There was no significant difference between groups (P> 0.05). (2) There was a positive correlation between serum SP-A level and m RNA level and SP-A protein level in BALF in MPP group and MPP group (P = 0.01; (3) There was no significant correlation between serum SP-A level in BALF and SP-A m RNA level in MPP with atelectasis group and pulmonary re-entry time (all P> 0.05). CONCLUSIONS: The levels of SP-A protein in serum and BALF of MPP patients are obviously decreased. The injury of alveolar type-2 cells in MPP may occur. The treatment of SP-A or the treatment of SP-A may have some significance on the recovery of MPP.