儿童呼吸道感染患者血清IP-10，MCP-1 平检测的临床意义

目的 研究皖南地区儿童呼吸道病原体感染的流行病学特点,探讨混合病原体感染患儿血清中干扰素诱生蛋白10(interferon-inducible protein-10,IP-10),单核细胞趋化蛋白-1( monogyte chemoattractant protein-1),MCP-1表达水平在急性呼吸道感染诊断中的应用价值。方法 收集2017年6月～2019年6月皖南医学院第一、二附属医院急性呼吸道感染患儿血标本,采用间接免疫荧光法检测呼吸道九项病原体IgM,分析不同年龄段呼吸道病原体感染的差异性。采用酶联免疫吸附试验检测混合感染患儿血清中IP-10,MCP-1的表达水平,分析炎症因子表达水平与疾病严重程度的相关性。结果 5 122例急性呼吸道感染患儿中,以肺炎支原体感染率最高,混合感染患儿共544例,以肺炎支原体联合呼吸道合胞病毒感染率最高。检测血清中的CRP,IP-10和MCP-1的表达水平相比较单独感染组,混合感染组升高更为明显,对比组之间的差异均具有统计学意义(F=1.045～4.889,均P<0.05)。相关性研究分析显示,混合感染组IP-10,MCP-1与CRP 表达水平呈正相关性(r = 0.612,P<0.001; r= 0.804,P<0.001)。结论 急性呼吸道感染患儿中,混合感染更易表现为咳嗽、鼻塞流涕及发热等症状,同时炎症反应增强,病情的严重程度增加,血清IP-10和MCP-1表达水平可作为急性呼吸道感染病情严重程度指标之一。

Clinical Significance of Detect Serum IP-10 and MCP-1 Levels in Children with Respiratory Infection

Objective To clarify the epidemiological characteristics of respiratory pathogen infection in children in south Anhui. Investigate the clinical characteristics of children with mixed pathogen infection and the expression level of IP-10,MCP-1 in the diagnosis of children with acute respiratory infection(ARI).Methods From June 2017 to June 2019, blood samples of hospitalized children withARI in the First and Second Affiliated Hospitals of Wannan Medical College were collected. Nine pathogens IgM of the respiratory tract was detected by indirect immunofluorescence. Analyze the differences of respiratory pathogen infection in different age groups.The expression levels of IP-10,MCP-1 in serum of children with mixed infection were detected by enzyme-linked immunosorbent assay. To analyze the relationship between the levels of inflammatory factors after mixed infection and the severity of disease in children. Results Among the 5 122 children with ARI. The rate of Mycoplasma pneumoniae infection was the highest. There were 544 cases of mixed infection, while MP combined with RSV was the highest.The expression levels of CRP, IP-10, MCP-1 in serum were all increased with different degrees.Compared with the single infection group, the mixed infection group showed more significant increase, and the difference was statistically significant(F=1.045～4.889,all P< 0.05).Correlation analysis showed that IP-10, MCP-1 was positively correlated with CRP expression level in the mixed infection group(r= 0.612,P<0.001; r= 0.804,P<0.001). Conclusion Children with mixed infection, the symptoms were more likely to be cough, nasal obstruction, runny nose and prolonged fever. Meanwhile, the inflammatory response was increased and the severity of the disease increased.The expression level of IP-10, MCP-1 can be used as an indicator of the severity of ARI.