论文部分内容阅读
目的:探讨婴幼儿肺炎支原体肺炎(MPP)促炎细胞因子和抗炎细胞因子水平的动态变化,探讨其临床意义及诊断价值。方法:收集疑似MP感染患儿73例,健康体检儿童60例,采用血清学方法检测MP-IgM,并分离培养鉴定MP;采用ELISA法测定MPP患儿急性期、恢复期及对照组促炎细胞因子(TNF-α、IL-8)和抗炎细胞因子(IL-10、IL-13)的水平。通过ROC曲线分析曲线下面积(AUC),比较各细胞因子对MPP的诊断效率,计算其敏感度和特异度。结果:经实验室检查,确诊MPP患儿46例,MPP患儿急性期促炎细胞因子(TNF-α、IL-8)水平明显高于恢复期及健康对照组,差异有统计学意义(P<0.05);急性期抗炎细胞因子IL-10水平明显低于恢复期和健康对照组,差异有统计学意义(P<0.05);急性期抗炎细胞因子IL-13水平明显高于恢复期和健康对照组,差异有统计学意义(P<0.05)。ROC曲线结果显示4种细胞因子AUC分别为0.768、0.862、0.564和0.717,IL-8在MPP中有较高的诊断价值(AUC接近0.9),其最佳分界值为102.57 pg/ml,诊断MPP的敏感度及特异度分别为78.2和89.1。结论:婴幼儿MPP发病过程中,促炎细胞因子(TNF-α、IL-8)始终处于高表达状态,抗炎因子IL-10低水平表达可能与MPP发病有关,提示机体免疫调节失控,同时以IL-13高水平表达的抗感染反应占优势。通过ROC曲线分析,IL-8可作为辅助诊断MPP的实用指标。
Objective: To investigate the dynamic changes of proinflammatory cytokines and anti-inflammatory cytokines in infants with Mycoplasma pneumoniae pneumonia (MPP), and to explore its clinical significance and diagnostic value. Methods: Seventy-three children with suspected MP infection and 60 healthy children were enrolled in this study. MP-IgM was detected by serological method and MP was isolated and cultured. The levels of pro-inflammatory cytokines (TNF-α, IL-8) and anti-inflammatory cytokines (IL-10, IL-13). The area under the curve (AUC) was analyzed by ROC curve, and the diagnostic efficiency of each cytokine to MPP was compared to calculate the sensitivity and specificity. Results: Forty-six children with MPP were diagnosed by laboratory tests. The levels of pro-inflammatory cytokines (TNF-α and IL-8) in acute phase of MPP were significantly higher than those in recovery and healthy controls (P <0.05). The level of anti-inflammatory cytokine IL-10 in acute phase was significantly lower than that in recovery phase and healthy control group (P <0.05). The level of anti-inflammatory cytokine IL-13 in acute phase was significantly higher than that in recovery phase And healthy control group, the difference was statistically significant (P <0.05). The ROC curve showed that the four cytokines AUC were 0.768,0.862,0.564 and 0.717 respectively. IL-8 had a high diagnostic value in MPP (AUC close to 0.9). The best cut-off value was 102.57 pg / ml. The diagnosis of MPP The sensitivity and specificity were 78.2 and 89.1, respectively. CONCLUSIONS: Inflammatory cytokines (TNF-α and IL-8) are always highly expressed in infants with MPP. Low expression of anti-inflammatory factor IL-10 may be related to the pathogenesis of MPP, suggesting that the immune regulation of the infant is out of control. Meanwhile, Anti-infective responses expressed at high levels of IL-13 predominate. By ROC curve analysis, IL-8 can be used as a useful diagnostic indicator of MPP.