支原体肺炎发病机制及临床分析

目的 探讨支原体肺炎免疫发病机制及其临床特点。方法 对485例有呼吸道感染的患儿进行血清抗肺炎支原体(mycoplasmapneumoniae,MP)IgM和咽拭子MPDNAPCR检测,同时对45例肺炎患儿进行血清IgG、IgM、总补体活性(CH50)和循环免疫复合物(CIC)测定。结果 MPDNAPCR检测结果与血清MP抗IgM结果有显著性差异(P<0.05);MP肺炎组CIC阳性率为44%(11/25);非MP肺炎组阳性率为10%(2/20),前者明显高于后者,差异有显著性(P<0.01);MP肺炎组血清IgG、IgM浓度高于非MP肺炎组,两组差异显著(P<0.05);而CH50则明显低于对照组(P<0.05)。结论 MPDNAPCR检测有利于早期诊断治疗;免疫复合物介导损伤可能与MP肺炎的发病有关。

Clinical analysis of the pathogenesis of mycoplasma pneumonia in children

Objective To study the clinical features and immune-mediated pathogenesis of mycoplasma pneumonia (MP) in children. Methods The DNA of mycoplasma in nasopharyngeal swabs was detected by PCR in 485 children with respiratory tract infection, and serum circulating immune complex (CIC), IgG, IgM, MP IgM, and CH50 were measured on the same day in 45 children with pneumonia. Results Significant difference was noted between the results of mycoplasma DNA PCR detection and those of serum IgM detection. The positivity rate of CIC was 44% in children with MP whereas that in the control group was only 10% (P<0.01). The levels of serum IgG and IgM in MP group was significantly higher and serum CH50 lower than those of the control group (P<0.05). Conclusion Mycoplasma DNA detection facilitates early diagnosis and treatment of MP, whose pathogenesis in children may be involved in immune-mediated mechanism.