Chkhaidze I, Kapanadze N
1Tbilisi State Medical University; 2Iashvili Central Children Hospital, Tbilisi, Georgia.
Georgian Med News. 2017 Jun(267):89-95.
In spite of many attempts to differentiate bacterial from viral disease and predict severity and outcome, the etiologic diagnosis of paediatric community acquired pneumonia and the estimation of potential outcomes remain unsolved problems in most cases. Mycoplasma pneumoniae is one of the major pathogens causing CAP in children. Although MP infection was traditionally thought to be a self-limited process, more and more severe cases even fatal cases of MP infections were reported in recent years. So it is essential for pediatricians to recognize severe or refractory or severe MP early, treat it promptly and prevent the progress of the disease. In recent years, several new biomarkers have been tested in children with CAP. Some of the biomarkers used for etiologic diagnosis in children with CAP and they also have been used the MP infection severity. Among traditional biomarkers, several cytokines appears to be effective both in selection of bacterial cases and in evaluation of severity. However, a precise cut-off level able to separate bacterial from viral cases and mild from severe cases has not been defined. Further studies enrolled with a large number of children with Mycoplasma pneumoniae is needed to be carried out to identify the potential utility of different cytokines as the good predictors.
尽管人们多次尝试区分细菌性疾病和病毒性疾病,并预测疾病的严重程度和转归,但在大多数情况下,儿童社区获得性肺炎的病因诊断以及潜在转归的评估仍然是未解决的问题。肺炎支原体是引起儿童社区获得性肺炎的主要病原体之一。虽然传统上认为支原体肺炎感染是一个自限性过程,但近年来报道了越来越多严重甚至致命的支原体肺炎感染病例。因此,儿科医生尽早识别严重、难治或重症支原体肺炎,及时进行治疗并预防疾病进展至关重要。近年来,几种新的生物标志物已在儿童社区获得性肺炎患者中进行了检测。其中一些生物标志物用于儿童社区获得性肺炎的病因诊断,也用于评估支原体肺炎感染的严重程度。在传统生物标志物中,几种细胞因子似乎在细菌性病例的筛选和严重程度评估中均有效。然而,尚未确定能够区分细菌性和病毒性病例以及轻度和重度病例的精确临界值。需要开展更多纳入大量肺炎支原体感染儿童的研究,以确定不同细胞因子作为良好预测指标的潜在效用。