肺炎支原体感染的哮喘患儿哮喘相关免疫学指标的变化
2009/06/24
背景：肺炎支原体（M. pneumoniae）为非典型致病菌，是导致肺炎的常见且重要的病原体。基于患者及动物模型外周血和痰液检测，研究发现，肺炎支原体感染参与了哮喘的发生过程，但来源于患者气道的直接证据较少。
目的：通过检测支原体肺炎患儿的外周血和支气管肺泡灌洗液（BALF）免疫学参数，评价肺炎支原体感染在哮喘中的作用。
方法：30名支原体肺炎患者和37名无肺炎支原体感染的患者入选本项研究，上述患者均已接受纤维支气管镜检查。回顾患者外周血细胞计数、免疫球蛋白（Ig）、BALF细胞计数和其它临床和实验室数据，并对其进行分析。
结果：与对照组相比，更多的支原体肺炎患者出现嗜碱性粒细胞计数增加（P = 0.033）。支原体肺炎组患者的血清免疫球蛋白IgA、IgM和IgG水平较对照组高（P值分别为0.008；0.011和0.019）。支原体肺炎患者BALF中嗜酸性粒细胞百分比介于0％～10％之间，而对照组介于0％～4％之间，两者具有临床显著性差异（P = 0.043）。支原体肺炎组BALF中嗜酸性粒细胞百分比与年龄、外周血嗜酸性粒细胞百分比和BALF淋巴细胞呈正相关（r分别为0.298，0.341，0.387；P值分别为0.030，0.014，0.006），而与外周血白细胞总数呈负相关（r = -0.387, p = 0.005）。
结论：上述结果显示支原体肺炎感染与哮喘有关，尤其是在年长儿童中。
（苏楠 审校）
Tang LF, et al. J Asthma. 2009 Apr;46(3):265-269
The change of asthma-associated immunological parameters in children with Mycoplasma pneumoniae infection.
BACKGROUND: Mycoplasma pneumoniae (M. pneumoniae), an atypical pathogen, is increasingly recognized as a common and important pathogen. Previous studies showed that M. pneumoniae infection may play a role in asthmatic mechanisms based on evidence collected from peripheral blood or sputum of patients or animal models. However, evidence reported from the airways of patients has been rare.
OBJECTIVE: To estimate the role of M. pneumoniae infection in asthma by measuring the immunological parameters from peripheral blood and bronchoalveolar lavage fluid (BALF) in pediatric patients with mycoplasma pneumonia.
METHODS: A total of 30 patients with mycoplasma pneumonia and 37 patients without M. pneumoniae infection undergoing fiberoptic bronchoscopy were reviewed. The peripheral blood cell count, immunoglobulins (Ig), BALF cell count, and other clinical and laboratory data were reviewed and analyzed.
RESULTS: There were significantly more patients with raised basophil counts in the M. pneumoniae group than that in the control group (p = 0.033). Serum immunoglobulin (Ig) A, IgM, and IgG levels in the M. pneumoniae group were significantly higher than those in the control group (p = 0.008, p = 0.011, and p = 0.019, respectively). The percentage of eosinophils in BALF cells was in the range 0 to 10% in M. pneumoniae patients, while it ranged between 0 and 4% in the control group with a significant difference (p = 0.043). In the M. pneumoniae group, we found that the percentage of eosinophils in the BALF cells was positively correlated with age, the percentage of peripheral eosinophils, and BALF lymphocytes (r = 0.298, p = 0.030; r = 0.341, p = 0.014; r = 0.387, p = 0.006; respectively) and negatively correlated with total peripheral white blood cell (r = -0.387, p = 0.005).
CONCLUSION: These results suggest that M. pneumonia infection is associated with the asthma mechanism, especially in older children.
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对哮喘患儿无症状状态、急性加重及恢复期中血清单核细胞趋化蛋白1的连续性评估
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