分析肺炎支原体肺炎患儿支气管肺泡灌洗液中细胞因子水平、细胞学发现和 MP-DNA 水平。
Analysis of cytokine levels, cytological findings, and MP-DNA level in bronchoalveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia.
机构信息
Department of Respiratory, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Department of Pediatrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
出版信息
Immun Inflamm Dis. 2023 May;11(5):e849. doi: 10.1002/iid3.849.
BACKGROUND
The present study was conducted to determine the inflammatory response in the lungs of children with Mycoplasma pneumoniae pneumonia (MPP).
METHODS
This study retrospectively analyzed cytokine levels, cytological findings, and M. pneumoniae (MP)-DNA level in the bronchoalveolar lavage fluid (BALF) of 96 children with MPP. The study utilized Spearman's correlation method to evaluate the contribution of BALF and blood parameters in MPP children.
RESULTS
(1) A total of 96 MPP children were classified into the Low MP-DNA MPP group (BALF MP-DNA ≤ 10 copies/mL) and the High MP-DNA MPP group (BALF MP-DNA > 10 copies/mL); the Non-fever MPP group (no fever during the entire course of pneumonia) and the Fever MPP group; the Defervescence MPP group (fever had subsided at the time of bronchoscopy) and the Fervescence MPP group; and the Mild MPP group and the Severe MPP group. (2) The High MP-DNA MPP, Fever MPP, Fervescence MPP, and Severe MPP groups had higher levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-α (TNF-α) in their BALF (all p < .05). (3) The proportions of neutrophils and macrophages in the BALF of the High MP-DNA MPP and Fever MPP groups increased and decreased, respectively (all p < .05). (4) In the BALF of MPP children, MP-DNA, IL-6, IL-10, TNF-α, and interferon gamma (IFN-γ) levels positively correlated with neutrophil proportion while negatively correlated with macrophage proportion (all p < .05). (5) The MP-DNA, IL-6, IL-10, TNF-α, and IFN-γ levels in the BALF of MPP children were positively correlated with the levels of C-reactive protein, procalcitonin, lactic dehydrogenase, fibrinogen, and d-dimer, while they were negatively correlated with the albumin level (all p < .05).
CONCLUSIONS
In children with MPP, the pulmonary inflammatory immune response was stronger in the High MP-DNA MPP, Fever MPP, Fervescence MPP, and Severe MPP groups. The relationship between pulmonary cytokine levels, MP-DNA load, and serum inflammatory parameters were found to be weak.
背景
本研究旨在确定肺炎支原体肺炎（MPP）患儿肺部的炎症反应。
方法
本研究回顾性分析了 96 例 MPP 患儿支气管肺泡灌洗液（BALF）中的细胞因子水平、细胞学发现和肺炎支原体（MP）-DNA 水平。研究采用 Spearman 相关分析方法评估 BALF 和血液参数在 MPP 患儿中的作用。
结果
（1）共 96 例 MPP 患儿分为低 MP-DNA MPP 组（BALF MP-DNA≤10 拷贝/ml）和高 MP-DNA MPP 组（BALF MP-DNA＞10 拷贝/ml）；非发热 MPP 组（肺炎全程无发热）和发热 MPP 组；退热 MPP 组（支气管镜检查时已退热）和发热 MPP 组；轻症 MPP 组和重症 MPP 组。（2）高 MP-DNA MPP、发热 MPP、发热 MPP 和重症 MPP 组 BALF 中白细胞介素（IL）-6、IL-10 和肿瘤坏死因子-α（TNF-α）水平较高（均 p＜0.05）。（3）高 MP-DNA MPP 和发热 MPP 组 BALF 中性粒细胞和巨噬细胞比例增加和减少（均 p＜0.05）。（4）在 MPP 患儿的 BALF 中，MP-DNA、IL-6、IL-10、TNF-α和干扰素-γ（IFN-γ）水平与中性粒细胞比例呈正相关，与巨噬细胞比例呈负相关（均 p＜0.05）。（5）MPP 患儿 BALF 中 MP-DNA、IL-6、IL-10、TNF-α和 IFN-γ水平与 C 反应蛋白、降钙素原、乳酸脱氢酶、纤维蛋白原和 D-二聚体水平呈正相关，与白蛋白水平呈负相关（均 p＜0.05）。
结论
在 MPP 患儿中，高 MP-DNA MPP、发热 MPP、发热 MPP 和重症 MPP 组的肺部炎症免疫反应更强。肺部细胞因子水平、MP-DNA 负荷与血清炎症参数之间的关系较弱。
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