Yano T, Saito S, Arikawa K, Kitazato Y, Koga H, Kumazawa J, Honda J, Oizumi K
Department of Respiratory Medicine, National Kyushu Medical Center.
Kansenshogaku Zasshi. 2001 Jan;75(1):36-41. doi: 10.11150/kansenshogakuzasshi1970.75.36.
Pathogenic mechanisms of mycoplasmal pneumonia is not fully understood at present though some kind of cell-mediated hypersensitivity is closely related to its mechanisms. Though eosinophilia in peripheral blood are sometimes revealed in patient with mycoplasmal pneumonia, it is not unclear whether eosinophils related to its pathogenesis, or not. We evaluated the clinical significance of ECP in serum and BAL fluid in patients with mycoplasmal pneumonia. The diagnosis of mycoplasmal pneumonia was confirmed both by serological diagnosis from paired serum and by the polymerase chain reaction (PCR) methods using specific primers of the Mycoplasma pneumoniae for detecting specific DNA from bronchial washing fluids. ECP level in serum were measured in 27 patients (11 male, 16 female, average age 31.7 yo) with mycoplasmal pneumonia by ELISA methods. ECP level in BALF were also measured in ten of all patients. The level of ECP in serum was high in 17 cases (63%) of the total cases. In addition the level of ECP in BALF was also high in all tested patients (10 cases). There was a correlation between serum ECP level and days from onset. There was also a correlation between serum ECP level and WBC counts, the degree of PaO2. These results suggested that ECP derived from activated eosinophils in the lung might in part play a role in the pathogenesis of mycoplasmal pneumonia.
目前,虽然某种细胞介导的超敏反应与其机制密切相关,但支原体肺炎的致病机制尚未完全明确。虽然支原体肺炎患者外周血有时会出现嗜酸性粒细胞增多,但嗜酸性粒细胞是否与其发病机制相关尚不清楚。我们评估了支原体肺炎患者血清和支气管肺泡灌洗液中嗜酸性粒细胞阳离子蛋白(ECP)的临床意义。支原体肺炎的诊断通过双份血清的血清学诊断以及使用肺炎支原体特异性引物从支气管冲洗液中检测特定DNA的聚合酶链反应(PCR)方法得以证实。采用酶联免疫吸附测定(ELISA)方法对27例(男11例,女16例,平均年龄31.7岁)支原体肺炎患者的血清ECP水平进行了检测。在所有患者中的10例患者中还检测了支气管肺泡灌洗液(BALF)中的ECP水平。在全部病例中,17例(63%)患者血清ECP水平升高。此外,在所有检测患者(10例)中,支气管肺泡灌洗液中的ECP水平也升高。血清ECP水平与发病天数之间存在相关性。血清ECP水平与白细胞计数、动脉血氧分压(PaO2)程度之间也存在相关性。这些结果表明,肺中活化嗜酸性粒细胞产生的ECP可能在支原体肺炎的发病机制中部分发挥作用。