Tang Lan Fang, Shi Yi Chen, Xu Ying Chun, Wang Cai Fu, Yu Zhong Sheng, Chen Zhi Min
Department of Pulmonology, the Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
J Asthma. 2009 Apr;46(3):265-9. doi: 10.1080/02770900802647557.
Mycoplasma pneumoniae (M. pneumoniae), an atypical pathogen, is increasingly recognized as a common and important pathogen. Previous studies showed that M. pneumoniae infection may play a role in asthmatic mechanisms based on evidence collected from peripheral blood or sputum of patients or animal models. However, evidence reported from the airways of patients has been rare.
To estimate the role of M. pneumoniae infection in asthma by measuring the immunological parameters from peripheral blood and bronchoalveolar lavage fluid (BALF) in pediatric patients with mycoplasma pneumonia.
A total of 30 patients with mycoplasma pneumonia and 37 patients without M. pneumoniae infection undergoing fiberoptic bronchoscopy were reviewed. The peripheral blood cell count, immunoglobulins (Ig), BALF cell count, and other clinical and laboratory data were reviewed and analyzed.
There were significantly more patients with raised basophil counts in the M. pneumoniae group than that in the control group (p = 0.033). Serum immunoglobulin (Ig) A, IgM, and IgG levels in the M. pneumoniae group were significantly higher than those in the control group (p = 0.008, p = 0.011, and p = 0.019, respectively). The percentage of eosinophils in BALF cells was in the range 0 to 10% in M. pneumoniae patients, while it ranged between 0 and 4% in the control group with a significant difference (p = 0.043). In the M. pneumoniae group, we found that the percentage of eosinophils in the BALF cells was positively correlated with age, the percentage of peripheral eosinophils, and BALF lymphocytes (r = 0.298, p = 0.030; r = 0.341, p = 0.014; r = 0.387, p = 0.006; respectively) and negatively correlated with total peripheral white blood cell (r = -0.387, p = 0.005).
These results suggest that M. pneumonia infection is associated with the asthma mechanism, especially in older children.
肺炎支原体作为一种非典型病原体,日益被认为是一种常见且重要的病原体。既往研究基于从患者外周血、痰液或动物模型收集的证据表明,肺炎支原体感染可能在哮喘机制中发挥作用。然而,来自患者气道的相关证据却很少见。
通过检测支原体肺炎患儿外周血和支气管肺泡灌洗液(BALF)中的免疫参数,评估肺炎支原体感染在哮喘中的作用。
回顾性分析30例支原体肺炎患者和37例未感染肺炎支原体且接受纤维支气管镜检查的患者。对其外周血细胞计数、免疫球蛋白(Ig)、BALF细胞计数及其他临床和实验室数据进行回顾性分析。
肺炎支原体组嗜碱性粒细胞计数升高的患者明显多于对照组(p = 0.033)。肺炎支原体组血清免疫球蛋白(Ig)A、IgM和IgG水平显著高于对照组(分别为p = 0.008、p = 0.011和p = 0.019)。肺炎支原体患者BALF细胞中嗜酸性粒细胞百分比在0%至10%之间,而对照组在0%至4%之间,差异有统计学意义(p = 0.043)。在肺炎支原体组中,我们发现BALF细胞中嗜酸性粒细胞百分比与年龄、外周嗜酸性粒细胞百分比及BALF淋巴细胞呈正相关(r分别为0.298,p = 0.030;r = 0.341,p = 0.014;r = 0.387,p = 0.006),与外周血白细胞总数呈负相关(r = -0.387,p = 0.005)。
这些结果表明,肺炎支原体感染与哮喘机制相关,尤其是在大龄儿童中。