| 李俊梅,郑成中,张 曼,胡玉杰,郭孝红.儿童难治性肺炎支原体肺炎的临床特点及血清IL-4、IL-6、IL-10、IFN-γ的变化分析[J].,2018,(24):4768-4772 |
| 儿童难治性肺炎支原体肺炎的临床特点及血清IL-4、IL-6、IL-10、IFN-γ的变化分析 |
| Clinical Characteristics of Children with Refractory Mycoplasma Pneumoniae and the Change of Serum IL-4, IL-6, IL-10 and IFN-γ Levels |
| 投稿时间：2018-08-06 修订日期：2018-08-30 |
| DOI：10.13241/j.cnki.pmb.2018.24.038 |
| 中文关键词: 儿童难治性支原体肺炎 临床特点 白介素-4 白介素-6 白介素-10 干扰素-γ |
| 英文关键词: Child refractory mycoplasma pneumonia Clinical features Interleukin-4 Interleukin-6 Interleukin-10 Interferon gam- ma-γ |
| 基金项目:北京市科学技术委员会基金项目(Z141107002514148) |
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| 中文摘要: |
| 摘要 目的：分析儿童难治性肺炎支原体肺炎(RMPP)的临床特点及血清白介素-4(IL-4)、白介素-6(IL-6)、白介素-10(IL-10)、干扰素-?酌(IFN-?酌)检测对RMPP的预测价值。方法：回顾性分析我院2014年6月~2018年1月收治的453例肺炎支原体肺炎(MMP)患儿临床资料，包含81例RMMP及372例普通MPP(GMPP)，分析和比较2组患儿的临床特征、临床表现、胸部影像学、肺外并发症、实验室检查结果，采用多因素Logistic回归分析RMPP发生的危险因素，并以受试者工作绘制特征(ROC)曲线分析各因素检测对RMPP的预测价值。结果：RMPP组年龄、热程、发热、寒战、呼吸音减弱、肺部浊音应该是肺部罗音、胸腔积液、大叶性肺炎、心脏损害、氧疗率、住院时间、白细胞计数、中性粒细胞百分比、前白蛋白、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、IL-4、IL-6、IL-10、IFN-?酌水平均显著高于GMPP组(P<0.05)。多因素Logistic回归分析显示血清IL-4、IL-6、IL-10、IFN-?酌水平为RMPP发生的独立危险因素(P<0.05)。血清IL-4、IL-6、IL-10、IFN-?酌及四者联合检测的曲线下面积分别为0.681、0.699、0.693、0.767、0.857，联合检测曲线下面积明显高于IL-4、IL-6、IL-10、IFN-?酌单独检测。结论：RMPPP患儿的年龄相对较高，且临床表现、胸部影像学、肺外并发症较GMPP患儿严重，更需吸氧治疗，延长住院时间。RMPP患儿血清IL-4、IL-6、IL-10、IFN-?酌水平明显上升，且四者联合检测对预测RMMP的发生临床价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the clinical characteristics of refractory mycoplasmal pneumonia (RMPP) in children with refrac- tory pneumonia and the predictive value of serum interleukin-4(IL-4), interleukin-6(IL-6), interleukin-10(IL-10) and interferon-γ (IFN-γ) detection for RMPP. Methods: A retrospective analysis of 453 cases of children with mycoplasma pneumoniae pneumonia (MMP) clini- cal data whocollected from June 2014 to January 2014 in our hospital, including 81 cases of RMPP and 372 cases of general MPP (GMPP), the clinical features, clinical manifestations, chest imaging, extrapulmonary complications, laboratory examination results in the both groups were analyzed and compared, multivariate Logistic regression was used to analyze the related factors of RMPP, the ROC curve was used to analyze the predictive value of each factor on RMPP. Results: Age, warmth, fever, chills, breath sounds, lung dullness, pleural effusion, lobar pneumonia, heart damage, oxygenation rate, hospital stay, levels of white cell count, neutrophil percent- age, preal- bumin, serum of IgM, IgA, IgG, IL-4, IL-6, IL-10, IFN-γ in the RMPP group were significantly higher than GMPP group, there was a sta- tistically significant difference(P<0.05). Multivariate logistic regression analysis showed that serum of IL-4, IL-6, IL-10, and IFN-γ levels were independent risk factors for RMPP(P<0.05). Areas under of serum of IL-4, IL-6, IL-10, IFN-γ, and the combined detection of the four groups were 0.681, 0.699, 0.693, 0.767, and 0.857, the area under the combined detection curve was significantly higher than that of serum of IL-4, IL-6, IL-10, IFN-γ were detected separately. Conclusion: RMPP children is relatively elder, the clini- cal manifestations, chest imaging, and extrapulmonary complications were more severe in children than those with GMPP, they need more oxygen therapy, extended hospital stay, the serum levels of IL-4, IL-6, IL-10 and IFN-γ of RMPP children were significantly in- creased and the combined detection of these four cytokines is of high clinical value for predicting the occurrence of RMMP. |
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