儿童支原体大叶性肺炎肺泡灌洗液细胞因子与局部炎症的相关性

doi:10.6040/j.issn.1671-7554.0.2022.0177

摘要/Abstract

摘要： 目的探讨儿童支原体大叶性肺炎肺泡灌洗液(BALF)中细胞因子与局部炎症的相关性。方法选取2021年9月至12月在山东大学齐鲁医院儿科住院的大叶性肺炎患儿80例,按宏基因组二代测序(mNGS)结果分为2组:肺炎支原体(MP)组(n=51)、肺炎链球菌(SP)组(n=29)。MP组按发热时间分为2个亚组:发热≤7 d组(n=22)、发热>7 d组(n=29);按胸腔积液分为另外2个亚组:有胸腔积液组(n=18),无胸腔积液组(n=33)。比较各组BALF中细胞因子水平。结果 MP组BALF中IL-6/IL-10、IL-1β/IL-10水平高于SP组(P=0.027;P=0.015)、IL-17/IL-10水平低于SP组(P=0.045)。 MP组中发热时间>7 d组BALF中IL-6/IL-10、IL-1β/IL-10、IL-17/IL-10、IL-12p70/IL-10、IL-4/IL-10水平高于发热时间≤7 d组(P=0.007;P=0.008;P=0.009;P=0.02;P=0.01)。MP组中有胸腔积液组BALF中IL-6/IL-10水平高于无胸腔积液组(P=0.005)。BALF中IL-6/IL-10、IL-1β/IL-10、IL-17/IL-10、IL-12p70/IL-10、IL-4/IL-10预测发热时间>7 d的曲线下面积(AUC)分别为0.721、0.719、0.716、0.691、0.712,IL-6/IL-10预测有胸腔积液的AUC为0.739。结论 MP大叶性肺炎BALF中IL-6、IL-1β、IL-17、IL-4水平与局部炎症反应相关,可作为评估患儿病情发展的重要指标。

关键词: 大叶性肺炎, 肺炎支原体, 儿童, 肺泡灌洗液, 细胞因子

Abstract: Objective To explore the relationship between cytokines in bronchoalveolar lavage fluid(BALF)with lobar pneumonia associated with mycoplasma pneumoniae(MP)in children. Methods A total of 80 children with MP lobar pneumonia treated during Sep. and Dec. 2021 were enrolled. The children were divided into two groups according to metagenome second generation sequencing(mNGS): MP group(n=51), and streptococcus pneumoniae(SP)group(n=29). According to fever duration, The MP group was subdivided into fever duration ≤7 d group(n=22)and >7 d group(n=29). According to pleural effusion, the MP group was subdivided into pleural effusion group(n=18)and non-pleural effusion group(n=33). Cytokines in BALF were compared. Results The levels of IL-6/IL-10 and IL-1β/IL-10 in the BALF of MP group were higher than those in the SP group(P=0.027, P=0.015), while the level of IL-17/IL-10 was lower in MP group than that in SP group(P=0.045). The levels of IL-6/IL-10, IL-1β/IL-10, IL-17/IL-10, IL-12p70/IL-10, IL-4/IL-10 in fever during >7 days were higher than those in the fever duration ≤7 days(P=0.007, P=0.008, P=0.009, P=0.02, P=0.01). The level of IL-6/IL-10 in the pleural effusion group was significantly higher than that in the non-pleural effusion group(P=0.005). The area under the curve(AUC)of IL-6/IL-10, IL-1β/IL-10, IL-17/IL-10, IL-12p70/IL-10, and IL-4/IL-10 in the fever duration >7day were 0.721, 0.719, 0.716, 0.691 and 0.712, respectively. The AUC of IL-6/IL-10 in the pleural effusion group was 0.739. Conclusion The levels of IL-6, IL-1β, IL-17 and IL-4 in BALF of MP lobar pneumonia are associated with the local inflammatory response, which can be used as important indicators to evaluate disease progression in children.

Key words: Lobar pneumonia, Mycoplasma pneumoniae, Children, Bronchoalveolar lavage fluid, Cytokine

中图分类号:

R725.6

张阿敏,李国盛,李福海. 儿童支原体大叶性肺炎肺泡灌洗液细胞因子与局部炎症的相关性[J]. 山东大学学报 (医学版), 2022, 60(11): 82-88.

ZHANG Amin, LI Guosheng, LI Fuhai. Bronchoalveolar lavage fluid cytokine profile contributes to discriminating local inflammation in children with mycoplasma lobar pneumonia[J]. Journal of Shandong University (Health Sciences), 2022, 60(11): 82-88.

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