重症肺炎患儿血清可溶性细胞间黏附分子-1水平的变化及临床意义

目的探讨重症肺炎患儿血清可溶性细胞间黏附分子-1(sICAM-1)水平的变化,以及不同病原体所致重症肺炎血清sICAM-1的水平及其临床意义。方法采用双抗体夹心酶联免疫吸附法测定40例重症肺炎患儿和43例普通肺炎患儿急性期、恢复期、以及48例健康对照组小儿血清sICAM-1水平。结果重症肺炎急性期血清sICAM-1水平明显高于重症肺炎恢复期,差异有非常显著性(P<0.01);与普通肺炎急性期与健康对照组比较,差异有非常显著性(P<0.01);重症肺炎恢复期血清sICAM-1水平与普通肺炎恢复期及健康对照组比较,则差异均无显著性(P>0.05);重症细菌性肺炎、病毒性肺炎、支原体肺炎、病毒与细菌混合感染性肺炎急性期血清sICAM-1水平比较,差异均无显著性(P>0.05)。结论重症肺炎患儿急性期血清sICAM-1水平较普通肺炎急性期明显增高,但不同病原体所致重症肺炎血清sICAM-1水平变化无统计学意义;sICAM-1参与了重症肺炎的炎症过程,其水平的高低可以作为肺炎病情轻重的判断指标之一。

Serum soluble intercellular adhesion molecule-1 in children with severe pneumonia

Objective To investigate the changes and clinical significance of serum soluble intercellular adhesion molecule-1(sICAM-1) in children with severe pneumonia and to ascertain whether the serum sICAM-1 levels are different in the severe pneumonia caused by different pathogens.Methods By double antibody sandwich ELISA technique,serum sICAM-1 levels at acute and recovery stage were determined in 40 children with severe pneumonia and 43 children with mild pneumonia as well as 48 healthy children.Results Serum sICAM-1 level at acute stage of the children with severe pneumonia was remarkably higher than that in recovery stage(P<0.01).Meanwhile,Serum sICAM-1 at acute stage was significantly higher in severe pneumonia group than those in same stage of mild pneumonia group and control group(P<0.01).However,there was no significant difference among the severe pneumonia,the mild pneumonia at recovery stage and the control group(P>0.05).No significant difference in serum sICAM-1 level was present among severe bacterial pneumonia,viral pneumonia,mycoplasmal pneumonia,the viral and bacterial coinfection at their acute stage(P>0.05).Conclusion Serum sICAM-1 level of severe pneumonia was remarkably higher than that io the mild pneumonia at acute stage,but there were no significant difference for serum sICAM-1 among the severe pneumonia caused by the different pathogens.Serum sICAM-1 may be an active inflammatory molecule in the pat-hogenesis of pneumonia and its level can be regarded as one of the markers in evaluating the severity of pneumonia in children.