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血清细胞因子谱有助于鉴别儿童肺炎支原体肺炎。

Serum cytokine profile contributes to discriminating M. pneumoniae pneumonia in children.

作者信息

Xu Xue-Feng, Li Xue-Jing, Liu Jin-Ling, Wu Lei, Chen Zhi-Min

机构信息

Department of Respiratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Department of Respiratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Cytokine. 2016 Oct;86:73-78. doi: 10.1016/j.cyto.2016.07.018. Epub 2016 Jul 29.

Abstract

BACKGROUND

To evaluate the role of serum cytokines in discriminating M. pneumoniae infection in children with community-acquired pneumonia (CAP).

METHODS

A prospective observational study was conducted. 385 hospitalized patients with CAP had only M. pneumoniae (MP group) infection; 321 hospitalized patients with CAP had no M. pneumoniae and other specific pathogen (control group) infections. Serum interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) were detected by flow cytometry.

RESULTS

In children younger than 5years, serum IL-6, TNF-α, and IFN-γ levels from MP group were significantly higher than those from control group. However in children 5-15years, serum IL-6, IL-10, and IFN-γ levels from MP group were significantly higher than those from control group. In the final multivariate logistic regression model for serum cytokine, moderately elevated IL-6, IL-10, and IFN-γ shows a higher prediction of development of M. pneumoniae pneumonia among CAP patients.

CONCLUSIONS

A specific cytokine pattern showed a higher prediction of M. pneumoniae pneumonia among CAP patients, further suggesting that serum cytokine pattern might be useful in differentiating infectious causative agents in children.

摘要

背景

评估血清细胞因子在鉴别社区获得性肺炎(CAP)患儿支原体感染中的作用。

方法

进行一项前瞻性观察研究。385例住院的CAP患儿仅感染肺炎支原体(MP组);321例住院的CAP患儿未感染肺炎支原体及其他特定病原体(对照组)。采用流式细胞术检测血清白细胞介素-2(IL-2)、IL-4、IL-6、IL-10、肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)。

结果

在5岁以下儿童中,MP组血清IL-6、TNF-α和IFN-γ水平显著高于对照组。然而,在5-15岁儿童中,MP组血清IL-6、IL-10和IFN-γ水平显著高于对照组。在血清细胞因子的最终多因素逻辑回归模型中,IL-6、IL-10和IFN-γ中度升高对CAP患者中肺炎支原体肺炎的发生具有较高的预测价值。

结论

特定的细胞因子模式对CAP患者中肺炎支原体肺炎具有较高的预测价值,进一步表明血清细胞因子模式可能有助于鉴别儿童感染的病原体。

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