肺炎支原体肺炎患儿转氨酶水平及其影响因素探讨

目的比较肺炎支原体肺炎（MPP）和非MPP患儿转氨酶水平,并探讨MPP患儿转氨酶水平的影响因素。方法分别检测99例MPP患儿、120例非MPP患儿和63例健康儿童的肝酶水平,并对MPP患儿谷丙转氨酶（ALT）水平与患儿年龄、病程、发热程度及时间、血常规WBC计数、外周血C-反应蛋白（CRP）水平及肺炎支原体（MP）IgM滴度进行相关分析。结果 MPP组患儿ALT、谷草转氨酶（AST）及γ-谷氨酰转移酶（γ-GT）的异常率分别为5.05%、37.37%和3.03%,其异常率及ALT、AST水平与非MPP组比较差异无统计学意义,但γ-GT水平显著高于非MPP组患儿（P〈0.05）,且MPP组患儿ALT水平与外周血CRP水平和MP-IgM滴度呈显著正相关（P〈0.05）,与患儿年龄、发热程度及时间、外周血WBC计数无显著相关。结论小儿MPP致肝功能损害并不常见,但MPP组患儿γ-GT水平显著高于非MPP组,且MPP组ALT水平与外周血CRP水平和MP-IgM滴度呈显著正相关,提示免疫损伤可能是小儿MPP致肝功能损害的主要机制之一。

Level of aminotransferases in children with mycoplasma pneumoniae pneumonia and its influence factors

Objective To compare the levels of aminotransferases between children with Mycoplasma pneu-moniae pneumonia （MPP） and those of non-MPP, and to explore the factors influencing the levels of aminotransferases in children with MPP. Methods Liver enzymes were detected in 99 children of MPP （MPP）, 120 of non-MPP （non-MPP group） and 63 healthy children （the control group）. The relationship of glutamic-pyruvic transaminase （ALT） levels with age, course of disease, degree and duration of fever, WBC count and C-reactive protein （CRP） of peripheral blood and MP-IgM titer was investigated. Results The abnormal rate of ALT, glutamic-oxalacetic transaminease （AST） and gam-ma-glutamyltransferase （γ-GT） in MPP group was 5.05%, 37.37% and 3.03%, respectively. There was no statistically sig-nificant differences in abnormal rate and the levels of ALT and AST between MPP group and non-MPP group, but γ-GT levels of MPP group were significantly higher than that of non-MPP group （P0.05）. ALT levels of MPP group showed sig-nificant positive relationship with CRP and MP-IgM titer （P0.05）, but no significant relationship with age, course of disease, degree and duration of fever, WBC count of peripheral blood. Conclusion Liver function impairment is not com-mon in children with MPP, but γ-GT levels of children with MPP are significantly higher than those of non-MPP. There were significant positive relationship between ALT levels of MPP group and CRP, MP-IgM titer. Immune injury might be one of the main mechanisms of MP-induced liver function impairment.