支原体感染对成人肺功能及呼出气一氧化氮的影响

doi:10.6040/j.issn.1671-7554.0.2024.1356

摘要/Abstract

摘要： 目的探讨支原体感染对成人肺功能及呼出气一氧化氮(fractional exhaled nitric oxide, FeNO)的影响。方法选取成人支原体感染患者94例,依据肺部影像学检查分为急性气管-支气管炎组(支气管炎组)52例、肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia, MPP)组42例,并随机选取同时期健康体检人群50位作为对照组。比较3组人群肺功能及FeNO的差异。结果相较于对照组,支气管炎组与 MPP 组的肺功能均出现不同程度的下降,3组人群的肺功能差异有统计学意义(P<0.05),而FeNO差异无统计学意义(P>0.05);其中,MPP 组与对照组在用力肺活量(forced vital capacity, FVC)、第 1 秒用力呼气容积(forced expiratory volume in one second,FEV₁)、一秒率(FEV₁/FVC)、呼气峰值流量(peak expiratory flow, PEF)、最大呼气中段流量(maximal mid-expiratory flow curve, MMEF)及上述各值占预计值的百分比(%pred)差异有统计学意义(P<0.017),支气管炎组与对照组在 FEV₁、FEV₁/FVC、PEF、MMEF及上述各值占预计值的百分比差异有统计学意义(P<0.017),MPP 组与支气管炎组仅在 FVC%pred、FEV₁%pred 及 MMEF%pred 的差异有统计学意义(P<0.017)。结论支原体感染患者的肺功能均下降,大、小气道均受损,以阻塞性通气功能障碍为主;MPP患者肺功能下降更为显著,小气道受损更为明显;3组人群FeNO无明显差异。

关键词: 支原体, 肺炎支原体肺炎, C-反应蛋白, 肺功能, 呼出气一氧化氮

Abstract: Objective To investigate the effects of Mycoplasma infection on pulmonary function and fractional exhaled nitric oxide(FeNO)production in adults. Methods Based on the results of pulmonary imaging examination, a total of 94 adult patients with Mycoplasma infection were enrolled, in which 52 patients suffered from acute trachea-bronchitis(bronchitis group)and 42 patients suffered from Mycoplasma pneumoniae pneumonia(MPP group). Fifty healthy individuals who underwent physical examination during the same period were selected as a control group. The differences in pulmonary function and FeNO among the three groups were compared. Results The differences in lung function among the three groups were statistically significant(P<0.05). However, there was no statistically significant difference in FeNO among the three groups(P>0.05). Specifically, the MPP group and the control group showed statistically significant differences in forced vital capacity(FVC), forced expiratory volume in one second(FEV₁), FEV₁/FVC, peak expiratory flow(PEF), maximal mid-expiratory flow curve(MMEF), and the percentage of each value relative to the predicted value(%pred)(all P<0.017). The bronchitis group and the control group showed statistically significant differences in FEV₁, FEV₁/FVC, PEF, MMEF, and the percentage of each value relative to the predicted value(all P<0.017). The MPP group and the bronchitis group showed statistically significant differences only in FVC%pred, FEV1%pred, and MMEF%pred(all P<0.017). Conclusion All patients with Mycoplasma infection have declined lung function, with damage to both large and small airways, and predominantly obstructive ventilation function impairment. Patients with MPP have even more significant decreases in lung function, with more pronounced damage to the small airways. There is no significant difference in FeNO among the three groups.

Key words: Mycoplasma, Mycoplasma pneumoniae pneumonia, C-reactive protein, Pulmonary function, Fractional exhaled nitric oxide

中图分类号:

R563.1

张如岗,殷悦,李岱云,段梦琦,刘桂莲,王瑛. 支原体感染对成人肺功能及呼出气一氧化氮的影响[J]. 山东大学学报 (医学版), 2025, 63(3): 71-75.

ZHANG Rugang, YIN Yue, LI Daiyun, DUAN Mengqi, LIU Guilian, WANG Ying. Impact of Mycoplasma infection on pulmonary function and fractional exhaled nitric oxide in adults[J]. Journal of Shandong University (Health Sciences), 2025, 63(3): 71-75.

参考文献

[1] Saraya T. Mycoplasma pneumoniae infection: basics[J]. J Gen Fam Med, 2017, 18(3): 118-125.
[2] Jacobs E, Ehrhardt I, Dumke R. New insights in the outbreak pattern of Mycoplasma pneumoniae[J]. Int J Med Microbiol, 2015, 305(7): 705-708.
[3] Ma JY, Guo PB, Mei SY, et al. Influence of COVID-19 pandemic on the epidemiology of Mycoplasma pneumoniae infections among hospitalized children in Henan, China[J]. Heliyon, 2023, 9(11): e22213. doi:10.1016/j.heliyon.2023.e22213
[4] Tahmasebi H, Babaeizad A, Mohammadlou M, et al. Reemergence of Mycoplasma pneumoniae disease: pathogenesis and new approaches[J]. Microb Pathog, 2024, 196: 106944. doi:10.1016/j.micpath.2024.106944
[5] 刘凯,付红敏,陆权. 儿童肺炎支原体肺炎的流行病学新进展[J].中华儿科杂志, 2024, 62(7): 696-699. LIU Kai, FU Hongmin, LU Quan. Advancement in epidemiology of Mycoplasma pneumoniae pneumonia in children in China[J]. Chinese Journal of Pediatrics, 2024, 62(7): 696-699.
[6] 刘玉英. 肺炎支原体感染的临床表现及其治疗的研究进展[J]. 抗感染药学, 2021, 18(6): 777-780. LIU Yuying. Clinical manifestations of Mycoplasma pneumoniae infection and its research progress of medication[J]. Anti-Infection Pharmacy, 2021, 18(6): 777-780.
[7] 中华医学会呼吸病学分会感染学组. 成人肺炎支原体肺炎诊治专家共识[J]. 中华结核和呼吸杂志, 2010, 33(9): 643-645.
[8] 宋元林, 郑劲平, 金美玲. 常规肺功能检查基层指南(2018年)[J]. 中华全科医师杂志, 2019, 18(6): 511-518. SONG Yuanlin, ZHENG Jinping, JIN Meiling. Basic guidelines for routine pulmonary function examination(2018)[J]. Chinese Journal of General Practitioners, 2019, 18(6): 511-518.
[9] 中国医药教育协会慢性气道疾病专业委员会, 中国哮喘联盟. 呼出气一氧化氮检测及其在气道疾病诊治中应用的中国专家共识[J]. 中华医学杂志, 2021, 101(38): 3092-3114.
[10] LYU TG, Chen J, Li HF, et al. Influenza A virus continues to circulate among children in Linyi, northern China, after the relaxation of COVID-19 control measures[J]. Sci Rep, 2024, 14(1): 30164. doi:10.1038/s41598-024-81542-4
[11] Tian SF, Chen YL, Su QR, et al. Pertussis clinical profile shift, severity, prediction in a tertiary hospital: a comparative study before, during, and after COVID-19 in Southern China[J]. J Infect Public Health, 2025, 18(1): 102610. doi:10.1016/j.jiph.2024.102610
[12] Zhang YX, Li Y, Wang Y, et al. Prospective cohort study on the clinical significance of interferon-γ, D-dimer, LDH, and CRP tests in children with severe Mycoplasma pneumonia[J]. Medicine, 2024, 103(41): e39665. doi:10.1097/MD.0000000000039665
[13] Chen P, Huang Z, Chen LM, et al. The relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory Mycoplasma pneumoniae pneumonia in children[J]. Sci Rep, 2021, 11(1): 2059. doi:10.1038/s41598-021-81853-w
[14] Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests[J]. Eur Respir J, 2022, 60(1): 2101499. doi:10.1183/13993003.01499-2021
[15] Li JL, Zhang H, Guo J, et al. Clinical features of Mycoplasma pneumoniae pneumonia in children without fever[J]. BMC Pediatr, 2024, 24(1): 52. doi:10.1186/s12887-023-04512-1
[16] 张海军, 董晓蕾, 蔺萃, 等. 支原体肺炎患儿的肺功能改变特点及其危险因素分析[J]. 天津医药, 2019, 47(11): 1166-1169. ZHANG Haijun, DONG Xiaolei, LIN Cui, et al. Characteristics and risk factors of pulmonary function changes in children with Mycoplasma pneumoniae pneumonia[J]. Tianjin Medical Journal, 2019, 47(11): 1166-1169.
[17] 汤艳芬, 王宇, 刘刚, 等. 成年肺炎支原体肺炎患者的肺功能特点分析[J]. 实用心脑肺血管病杂志, 2017, 25(5): 72-75. TANG Yanfen, WANG Yu, LIU Gang, et al. Pulmonary function features of adult patients with Mycoplasma pneumoniae pneumonia[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2017, 25(5): 72-75.
[18] 姜岱山, 卞婷婷, 李山峰, 等. 成人肺炎支原体感染患者的临床特征及治疗研究[J]. 中国全科医学, 2016, 19(S1): 200-202. JIANG Daishan, BIAN Tingting, LI Shanfeng, et al. Clinical characteristics and treatment of adult patients with Mycoplasma pneumoniae infection[J]. Chinese General Practice, 2016, 19(S1): 200-202.
[19] Metsälä R, Ala-Korpi S, Rannikko J, et al. Mycoplasma pneumoniae may cause dyspnoea and hospitalisations in young healthy adults[J]. Eur J Clin Microbiol Infect Dis, 2021, 40(7): 1427-1431.
[20] Guo ZQ, Gu SY, Tian ZH, et al. A comprehensive review of Mycoplasma pneumoniae infection in chronic lung diseases: recent advances in understanding asthma, COPD, and bronchiectasis[J]. Front Med, 2024, 11: 1437731. doi:10.3389/fmed.2024.1437731
[21] Medina JL, Brooks EG, Chaparro A, et al. Mycoplasma pneumoniae CARDS toxin elicits a functional IgE response in Balb/c mice[J]. PLoS One, 2017, 12(2): e0172447. doi:10.1371/journal.pone.0172447
[22] Tsai TA, Tsai CK, Kuo KC, et al. Rational stepwise approach for Mycoplasma pneumoniae pneumonia in children[J]. J Microbiol Immunol Infect, 2021, 54(4): 557-565.
[23] Yin SS, Ma FL, Gao X. Association of Mycoplasma pneumoniae infection with increased risk of asthma in children[J]. Exp Ther Med, 2017, 13(5): 1813-1819.
[24] 王英媛, 蔡栩栩, 尚云晓,等. 肺炎支原体感染对哮喘儿童呼出气一氧化氮及肺功能影响的研究[J]. 国际儿科学杂志, 2017, 44(7): 491-494. WANG Yingyuan, CAI Xuxu, SHANG Yunxiao, et al. The effects of Mycoplasma pneumoniae infection on the exhaled nitric oxide level and lung function in asthma children [J]. International Journal of Pediatrics, 2017, 44(7): 491-494.
[25] 韩红, 安红, 高超, 等. 呼出气一氧化氮与血清hs-CRP、 sB7-H3联合检测在儿童肺炎支原体肺炎中的诊断价值[J]. 河北医科大学学报, 2020, 41(7): 838-840.
[26] Hagman K, Nilsson AC, Hedenstierna M, et al. Outcomes of adjunctive corticosteroid treatment on hypoxemic adults hospitalised for Mycoplasma pneumoniae pneumonia: a retrospective cohort study[J]. Clin Infect Dis, 2024: ciae451. doi:10.1093/cid/ciae451

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