ABSTRACT
Objective To investigate the specpfic electric fiberobronchoscopic manifestations of refractory Mycoplasma pneumoniae pneumonia(RMPP) and explore the level of IL-17,IL-18,PTX3 in bronchoalveolar lavage fluid(BALF) and their clinical sigfinance.Methods To select patients who were diagnosed as MPP and examined by fiberobronchoscopy in acute stage.Dividing them into groups:(1) RMPP group (60cases):dividing RMPP patients into three groups according to if they were treated by systemic corticosteroids or immunoglobulin before the examination of fiberbronchoscope,① RMPP-A group:both are not used.②RMPP-B group:use systemic corticosteroids.③ RMPP-C:both are used.(2)general MPP group(35 cases).15 children with foreign body in bronchus were enrolled as control group.Firstly,to analysis the electric fiberobronchoscopic manifestations of all the cases.Secondly,the cases who had BALF samples in all group were selected,the levels of IL-17,IL-18 and PTX3 are detected by ELISA.Results Under electric fiberobronchoscopy,that the proportions of RMPP group with mucosal erosion,necrotic mucous membrane peeling,sputum bolt blockage in bronchial lumen or moulding are higher than general MPP group.The levels of IL-17,IL-18 and PTX3 in BALF of all MPP cases are higher than control group (P ＜ 0.05),but only the difference of IL-18 between RMPP group and general MPP group has statistical significance (P ＜ 0.05).The levels of IL-17,IL-18 and PTX3 in BALF of RMPP-B group are all higher than RMPP-A group (P ＜ 0.05).Conclusion Mucosal erosion,necrotic mucosa peeling and sputum bolt,moulding are the characteristic manifestations of RMPP,and can help identify RMPP.IL-17,IL-l8 and PTX3 all participated in the pathogenesis of RMPP.Only the level of IL-18 in BALF can be the predictive marker of RMPP.Systemic corticosteroids may inhibit the levels of IL-17,IL-18 and PTX3 of RMPP patients.
ABSTRACT
Objective To explore the levels and clinical significances of T-cell subset,interleukin (IL)-6,interferon(IFN)-γ,and monocyte chemotactic protein(MCP)-1 in bronchoalveolar lavage fluid (BALF) of children with mycoplasma pneumoniae pneumonia(MPP).Methods Thirty-six children with pneumonia were admitted in our hospital from October 2014 to March 2016.They were divided into refractory mycoplasma pneumoniae pneumonia (RMPP) group (n=18) and MPP group(n=18).Sixteen cases with bronchial foreign body were selected as the control group.The levels of IL-6,MCP-1,IFN-γ and T-cell subset in BALF were detected by ELISA and alkaline phosphatase-anti-alkaline phosphatase(APAAP) bridging enzyme linked immunosorbent assay.Results (1)The levels of CD3 +and CD8 +T cells in BALF of MPP group and RMPP group were higher than those in the control group(P<0.05),but there were no significant differences between the two groups (P>0.05).(2) The level of IL-6 in acute phase of RMPP group was higher than that in the control group(P<0.05).The levels of IL-6 in acute phase of RMPP group and MPP group were both higher than that in recovery period(P<0.05,respectively).(3)The levels of IFN-γ in the acute phase of RMPP group and MPP group were higher than that in the control group,and the differences were statistically significant(P<0.05).The IFN-γ levels in acute and recovery phases of RMPP group were both significantly higher than those in MPP group respectively(P< 0.05).(4)The level of MCP-1 in BALF in control group was lower than those in the acute phase of RMPP group and MPP group(P<0.05).The level of MCP-1 in RMPP acute group was significantly higher than that in MPP acute group,and higher in acute phase than those in recovery phase both in two groups(P<0.05).Conclusion There are cell immune regulation and function disorders when children are infected mycoplasma pneumoniae. IL-6, IFN-γ and MCP-1 may participate in the pathogenesis of MPP,and more importantly,IFN-γ and MCP-1 may be the important indicator to forecast the severity of MPP.