Guo Shan-Chun, Xu Chuan-Wei, Liu Yu-Qin, Wang Jia-Fen, Zheng Zhen-Wen
Department of Pediatrics, Binzhou People's Hospital, Binzhou, Shandong 256610, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Aug;15(8):619-22.
To investigate the changes in plasma levels of thrombomodulin (TM) and D-dimer (DD) in children with different types of Mycoplasma pneumoniae pneumonia (MPP), and their role in the pathogenesis of MPP in children.
Fifty-two children with MMP were divided into lobar pneumonia (n=30) and interstitial pneumonia groups (n=22) and another 30 healthy children were selected as the control group. Plasma levels of TM and D-D were measured using enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetric assay, respectively.
The lobar pneumonia, interstitial pneumonia and control groups had median plasma TM levels of 23.83, 15.56 and 8.78 μg/L respectively, with significant differences between the three groups (P<0.01). The lobar pneumonia and interstitial pneumonia groups had significantly higher plasma TM levels than the control group (P<0.01), and the lobar pneumonia group had a significantly higher plasma TM level than the interstitial pneumonia group (P<0.05). Median plasma D-D levels in the lobar pneumonia and interstitial pneumonia groups were significantly higher than the reference value (P<0.01). The lobar pneumonia group had a significantly higher plasma D-D level than the interstitial pneumonia group (0.35 μg/mL vs 0.13 μg/mL; P<0.01), and the percentage of patients with elevated plasma D-D levels was significantly higher in the lobar pneumonia group than in the interstitial pneumonia group (87% vs 59%; P<0.05).
Children with MPP, especially those with lobar pneumonia, have increased plasma levels of TM and D-D. This suggests that damage to vascular endothelial cells and blood hypercoagulability may be involved in the pathogenesis of MPP.
探讨不同类型小儿支原体肺炎(MPP)患儿血浆血栓调节蛋白(TM)和D - 二聚体(DD)水平的变化及其在小儿MPP发病机制中的作用。
将52例MPP患儿分为大叶性肺炎组(n = 30)和间质性肺炎组(n = 22),另选取30例健康儿童作为对照组。分别采用酶联免疫吸附测定法和乳胶增强免疫比浊法检测血浆TM和D - D水平。
大叶性肺炎组、间质性肺炎组和对照组血浆TM水平中位数分别为23.83、15.56和8.78μg/L,三组间差异有统计学意义(P<0.01)。大叶性肺炎组和间质性肺炎组血浆TM水平均显著高于对照组(P<0.01),且大叶性肺炎组血浆TM水平显著高于间质性肺炎组(P<0.05)。大叶性肺炎组和间质性肺炎组血浆D - D水平中位数均显著高于参考值(P<0.01)。大叶性肺炎组血浆D - D水平显著高于间质性肺炎组(0.35μg/mL对0.13μg/mL;P<0.01),大叶性肺炎组血浆D - D水平升高患者的百分比显著高于间质性肺炎组(87%对59%;P<0.05)。
MPP患儿,尤其是大叶性肺炎患儿,血浆TM和D - D水平升高。这提示血管内皮细胞损伤和血液高凝状态可能参与了MPP的发病机制。