肺炎支原体与成人呼吸道感染关系的初步探讨

本文探讨肺炎支原体(MP)与成人呼吸道感染的关系。提示肺炎支原体是成人呼吸道感染的重要病原体之一,可能也是慢性阻塞性肺病的病因或急性发作的原因之一。     

肺炎支原体感染引起的小儿肺炎支原体肺炎与细胞因子的相关性分析

目的：探讨肺炎支原体感染引起的小儿肺炎支原体肺炎(MPP)与细胞因子的相关性。方法选择61例入住泰安市中心医院儿科的 MPP 患儿作为实验组,其中重症27例,轻症34例。另选取同期年龄、性别相匹配的正常体检儿童37名为对照组。采用酶联免疫吸附法对两组小儿血清 IL-15、IL-17进行检测。比较重症组、轻症组及对照组血清 IL-15、IL-17水平,重症组与轻症组急性期及恢复期患儿血清 IL-15、IL-17水平。结果①重症组血清 IL-17与 IL-15水平均高于轻症组及对照组(P <0.05),且轻症组血清上述指标水平均高于对照组(P <0.05);②重症组急性期患者血清 IL-17及 IL-15水平均高于恢复期与对照组(P <0.05);③MPP 重症组急性期及恢复期 IL-17及 IL-15水平均高于轻症组(P <0.05)。结论 MPP 患儿发病严重程度随着 IL-15及 IL-17水平的上升而增大,二者可作为评判 MPP 患儿病情严重程度的指标。     

姜黄素对肝纤维化大鼠肝组织中NF-κB及ERK-1 mRNA表达的影响

目的 探讨核转录因子-κB(nuclear factor kappa B,NF-κB)及细胞外信号调节激酶(extracegular signal-reglulated kinase,ERK)mRNA在CCl4致实验性肝纤维化大鼠肝组织中的表达及姜黄素(curcumin,CUR)对它们的影响.方法 建立CCl4致大鼠实验性肝纤维化的模型,用免疫组化法比较正常组、模型组及CUR组的α平滑肌肌动蛋白(α-SMA)的表达,用RT-PCR法比较各组肝组织NF-κB及ERK-1 mRNA的表达.结果 模型组中,ERK-1及NF-κB mRNA的表达均增高,而CUR组α平滑肌肌动蛋白则较模型组低,NF-κB及ERK-1 mRNA的表达也降低.结论 CUR可能通过抑制α-SMA的表达,减弱NF-κB诱导的肝星状细胞的活化及抑制ERK-1促肝星状细胞的增殖,从而产生抗四氯化碳诱导的大鼠肝纤维化的作用.     

炎性细胞因子在儿童肺炎支原体肺炎中的表达及其在免疫学发病机制中的作用

目的:观察肺炎支原体肺炎(MPP)患儿炎性细胞因子水平,并探讨其在免疫学发病机制中的作用。方法:采用前瞻性研究方法,选择2016年1月至2019年3月在成都医学院第一附属医院确诊的MPP患儿81例作为研究对象,根据急性期病情严重程度分为重症组(37例)和轻症组(44例)。于急性期(发病3～5 d)、恢复期(发病8～15...     

肺炎支原体感染与哮喘关系探讨

肺炎支原体 (MP)在人类的致病地位已受到临床医生的广泛重视 ,其可引起多系统器官的疾病 ,而我们发现于 MP感染发病高峰支气管哮喘发病率亦明显增高。为此本文检测了支原体感染患儿外周血T淋巴细胞趋化值及总 Ig E,旨在探讨它们之间的关系。1　资料与方法根据 ELISA法检测肺炎支原体特异抗体滴度≥ 1∶ 80确诊 MP感染患儿 5 7例 (MP感染组 ) ,其中男 3 6例 ,女 2 1例 ,年龄 2 6月龄至 1 2岁。根据1 997年中华医学会规定的诊断标准 ,确诊支气管哮喘发作期患儿 5 2例 (支气管哮喘组 ) ,其中男 3 2例 ,女 2 0例 ,年龄 1 3月至 1 2岁。幼…     

儿童哮喘与肺炎支原体感染检验结果及相关性探讨

目的观察哮喘患儿的肺炎支原体(MP)感染检验结果,分析儿童哮喘与与肺炎支原体感染的相关性。方法选择125例哮喘患儿为观察组(n=125),并选择同时期125例体检正常儿童为对照组(n=125),采用酶联免疫吸附法检测两组患儿的肺炎支原体抗体(MP-IgM)阳性率。结果观察组的MP-IgM阳性率显著高于对照组(P0.05);7岁年龄段儿童是MP感染的高危人群。结论 MP感染是儿童哮喘的重要诱发因素,哮喘急性发作期患儿建议优先考虑MP感染的可能性。     

姜黄素通过过氧化物酶体增生物激活受体-γ在大鼠实验性结肠炎中发挥抗炎作用

背景：研究显示姜黄素可激活过氧化物酶体增生物激活受体（PPAR）-γ，抑制三硝基苯磺酸（TNBS）诱导的大鼠结肠炎症。目的：以姜黄素和PPAR-γ拮抗剂GW9662单独或联合干预结肠炎模型大鼠，探讨姜黄素在大鼠实验性结肠炎中的抗炎机制。方法：以直肠内注入TNBS／乙醇溶液制备大鼠结肠炎模型。模型大鼠分别腹腔注射二甲基亚砜（DMSO）、姜黄素、GW9662或GW9662＋姜黄素2周，评价各组大鼠的死亡率、结肠损伤评分、血清促炎因子白细胞介素（IL）-2和抗炎因子IL-10水平以及结肠组织PPAR-γ和核因子（NF）-κB的表达。结果：与模型对照组相比，姜黄素能明显降低大鼠死亡率、结肠黏膜大体、组织学损伤评分和血清IL-2水平，升高血清IL-10水平，结肠组织PPAR-γ表达增高，NF-κB表达减低（P〈0．05）；GW9662＋姜黄素组大鼠结肠炎症无明显改善。正常对照组、模型对照组和姜黄素组PPAR-γ与NF-κB的表达均呈负相关（P〈0．01）。结论：姜黄素可通过PPAR-γ途径负性调节NF-κB的表达，在TNBS诱导的大鼠结肠炎中发挥抗炎作用。     

支原体感染

儿童肺炎支原体肺炎临床特征及肺外并发症438例分析；成人肺炎支原体感染19例临床分析；泌尿系支原体感染的耐药性分析；解脲支原体感染与子宫颈炎的关系；肺炎支原体感染致肺外并发症49例；肺炎支原体脑炎患儿血清细胞因子干扰素；     

肺炎支原体感染研究进展

肺炎支原体是呼吸道常见致病原,常引起呼吸道感染及各种肺外并发症。本文就肺炎支原体的致病机制等方面的进展作一综述。     

细胞因子与肺炎支原体感染的相关研究进展

肺炎支原体（MP）是目前下呼吸道感染的重要病原体,其确切的致病机制还不十分明确。近几年细胞因子在MP感染中的作用引起了越来越多的重视,现就细胞因子在MP感染发病机制中的作用作以下综述。     

肺炎支原体感染小鼠Th1／Th2平衡状况及Tim-3mRNA的表达

目的通过检测Tim-3mRNA的表达水平及IFN-7、IL-4的含量,初步探讨肺炎支原体感染鼠Th1／Th2细胞的动态变化及Tim～3的免疫调控作用。方法通过滴鼻感染建立肺炎支原体肺炎小鼠模型,观察小鼠的一般状况,分别于感染后3d、5d、7d、14d、21d取材,应用RT—PCR方法检测肺组织和脾脏Tim-3mRNA的表达;采用ELISA法检测肺泡灌洗液中细胞因子IFN～γ、IL-4的含量。结果实验组IFN-γ于3d出现升高（t=2．309,P〈0．05）,5dIFNY开始下降,而IL-4于3d开始升高并一直持续到7d（t-6．436,P〈0．05）,之后逐渐恢复正常,肺组织和脾脏Tim-3mRNA的表达均于5d达到峰值（t=4．727,P〈0．05;t=7．962,P〈0．05）,且肺组织和脾脏Tim-3mRNA表达量与L-4呈正相关（r=0．561,P〈0．05;r=0．462,P〈0．05）,从5d开始与IFN-γ呈负相关（r=0．379,P〈0．05;r=0．431,P〈0．05）。结论小鼠感染肺炎支原体后Th1／Th2失衡,以Th2介导的免疫反应为主;Tim3可能参与了感染后对Th1细胞的负调控。     

A retrospective study of azithromycin and ceftizoxime for the management of children with Mycoplasma pneumoniae pneumonia

The aim of this study was to compare the clinical efficacy of azithromycin and ceftizoxime (AC) and erythromycin and amoxicillin/sulbactam (EAS) in the treatment of children with Mycoplasma pneumoniae pneumonia (MPP).In this retrospective study, a total of 92 eligible children with MPP were included, and they were divided into a treatment group (n = 46) and a control group (n = 46). All patients were treated with intravenous ambroxol, and nebulized inhalation of budesonide and terbutaline. In addition, patients in the treatment group received AC. Patients in the control group underwent EAS. All patients in both groups were treated for a total of 10 days. Outcomes consist of erythrocyte sedimentation rate, C-reactive protein, serum lactate dehydrogenase, and interleukin 6, fever clearance time, time of cough disappearance, time of rale disappearance, time of signs disappeared by X-ray, and adverse events. All outcomes were measured after 10-day treatment.After treatment, patients who received AC exerted better improvements in erythrocyte sedimentation rate (P < .01), C-reactive protein (P < .01), serum lactate dehydrogenase (P < .01), interleukin 6 (P < .01), fever clearance time (P < .01), time of cough disappearance (P < .01), time of rale disappearance (P < .01), and time of signs disappeared by X-ray (P < .01), than those in patients who received EAS. In addition, there were not significant differences in adverse events between 2 groups.The results of this study showed that AC may benefit more than EAS for the children with MPP.     

Thromboembolic complications of Mycoplasma pneumoniae pneumonia in children

Background

Thromboembolism is less common in children than in adults, but it is frequently associated with Mycoplasma pneumoniae infection in many cases. This study aimed to investigate the clinical characteristics of pediatric M. pneumoniae pneumonia complicated with thromboembolism.

Methods

Hospitalized patients with M. pneumoniae pneumonia complicated by thromboembolism were enrolled from January 2012 to December 2021 in Beijing Children's Hospital, Capital Medical University, China. The data on clinical manifestations, laboratory tests, and treatment were evaluated.

Results

A total of 49 cases were enrolled, with a mean age of 7.9 years old, including 27 boys and 22 girls. Consolidation of pulmonary lobe or segment was observed in 95.9% (47/49) of the cases, whereas interstitial change was found only in two patients; 85.7% (42/49) of patients had pleural effusion. Pulmonary vascular thromboembolism was most common in 35 patients, whereas 13 cases had thromboembolism of multiple anatomic sites. The levels of C-reaction protein, lactate dehydrogenase, and erythrocyte sedimentation rate were all increased, with a mean value of 54.08 ± 52.27 g/L, 451.12 ± 218.76 U/L, 43.40 ± 29.43 mm/h, respectively. Blood coagulation test showed that all 49 patients had elevated D-dimer values (median 3.81 ng/ml, range, 0.34–48 ng/ml) and normal PT. aPTT.LA was positive in 74.3% (26/35) of the cases. aCL-IgM was positive in 66.7% (26/39) of the cases. aβ2GPI-IgM was positive in 79.4% (27/34) of the cases. The prognosis was generally good in this group.

Conclusion

Pulmonary arteriovenous thromboembolism is the most common thromboembolism complicated in MPP, and cerebral artery embolism and cardiac thrombosis are common in extrapulmonary thromboembolism. In the cases of MPP with thromboembolic complications, pulmonary consolidation with pleural effusion is the main characteristic. About two thirds of the cases are positive for antiphospholipid antibodies.     

Cytokine secretion in children with acute Mycoplasma pneumoniae infection and wheeze

The aim of this study was to evaluate cytokine secretion in children with acute Mycoplasma pneumoniae infection and wheeze. We studied 25 patients aged 2-14 years with an acute episode of wheezing (15 with acute M. pneumoniae infection) and 16 healthy controls of similar gender and age (8 with laboratory evidence of asymptomatic acute M. pneumoniae infection). Serum interleukin (IL)-2, interferon (IFN)-gamma, IL-4, and IL-5 concentrations were measured in samples obtained at enrollment, using enzyme-linked immunosorbent assay kits.In the presence of wheezing, IL-5 concentrations were significantly higher in subjects with acute M. pneumoniae infection (33.415 +/- 22.138 pg/mL) than in those without such infection (2.320 +/- 1.846 pg/mL, P < 0.0001). The children with acute M. pneumoniae infection and wheeze had higher IL-5 concentrations (33.415+/-22.138 pg/mL) than those with asymptomatic acute infection and without wheeze (1.740 +/- 2.299 pg/mL, P < 0.0001). No significant between-group differences were observed in terms of IL-2, IFN-gamma, or IL-4 levels, or the prevalence of atopy.Our results show that children with wheezing and acute M. pneumoniae infection have a specific cytokine profile characterized by a significant increase in serum levels of IL-5. This immune response may be important for understanding the pathophysiological mechanisms by which this pathogen contributes to the development of wheeze-related symptoms, and for identifying new treatment strategies.     

肺炎支原体肺炎患儿血清白介素17和白介素23表达的意义

目的分析并评价肺炎支原体肺炎患儿血清白介素17和白介素23表达情况。方法将我院自2014年1月至2014年7月期间收治的107例肺炎患儿按照肺炎支原体抗体检测情况分为肺炎支原体肺炎组52例(观察组)与其他肺炎组55例(对照组)。全部儿童均进行血清IL-17、IL-23、肺炎支原体抗体、白细胞计数、中性粒细胞、C反应蛋白等进行测定。结果肺炎支原体肺炎组患儿血清IL-17及IL-23含量最高(P均0.01)。其中,肺炎支原体肺炎组的血清IL-17和IL-23含量均高于其他肺炎组(P均0.05)。两组的中性粒细胞数与IL-17及IL-23含量均呈正相关(P均0.05)。结论白介素17和白介素23在肺部肺炎支原体感染过程中参与免疫应答,可能与肺炎支原体清除过程有关。     

Role of prednisolone treatment in severe Mycoplasma pneumoniae pneumonia in children

Mycoplasma pneumoniae pneumonia (MP) is responsible for 10-40% of cases of pediatric community-acquired pneumonia. Occasionally, progression to severe pneumonia occurs despite appropriate antibiotic therapy. We retrospectively evaluated the effect of prednisolone in 15 children with MP whose clinical and radiographic course worsened despite broad-spectrum antibiotics, including appropriate macrolides. The mean ( +/- SD) age was 6.1 +/- 1.9 years, and 10 were boys. All children had received macrolides at presentation, but they had persistent fever and progressively worsening radiographic findings. In addition to broad-spectrum antimicrobial therapy, we added prednisolone (1 mg/kg for 3-7 days, then tapered over 7 days) on day 6 (+/-1.5 days) of admission. Fourteen children became afebrile within 24 hr, and their clinical status and radiographic findings improved over several days. The white blood cell count at presentation was 7,500 +/- 2,000/mm3, with a proportion demonstrating lymphopenia (lymphocyte differential, 19.7 +/- 5.7%). In conclusion, corticosteroid treatment appeared to be temporally associated with clinical and radiographic improvement, and may be helpful for reducing morbidity in children with macrolide-nonresponsive severe MP. Further studies may be warranted.     

肺炎衣原体、支原体在哮喘致病机制中的作用

肺炎衣原体、支原体在哮喘致病机制中的作用引起了国际学者极大的兴趣。随着对肺炎衣原体、支原体与哮喘相关性认识程度的加深,结合众多学者所做的富有成效的研究成果,现将肺炎衣原体、支原体感染在哮喘致病机制中作用的研究进展作一综述。