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目的:分析唐山某医院儿童社区获得性肺炎(CAP)病原学特征,并探讨社区获得性肺炎病原学与免疫状况的相关性。方法:选取2014年1月至2015年8月在我院进行治疗的CAP患儿136例为病例组,其中喘息性CAP组81例,非喘息性CAP组55例;选取健康儿童40例为对照组。对CAP患儿进行病原学分析,检测并比较两组C反应蛋白(CRP)、血清降钙素(PCT)、白细胞计数(WBC)、中性粒细胞(NUET)等指标水平及免疫因子CD_4~+、CD_8~+T细胞水平。结果:本组病例以细菌感染为主(40例,29.41%),细菌感染以肺炎链球菌感染为主(16例,40.00%);CAP患儿的CRP、PCT水平均明显高于对照组,其中,细菌感染组CRP、PCT水平最高,其次为肺炎支原体感染组、混合感染组(P<0.05);细菌感染组Ig G、Ig M、Ig E水平最高,其次为肺炎支原体感染组、混合感染组(P<0.05),5组Ig A水平差异无统计学意义(F=1.879,P=0.265);细菌感染组CD+8T细胞水平最高,而CD4~+T细胞、CD_4~+/CD_8~+水平最低,肺炎支原体感染组、混合感染组次之(P<0.05)。结论:体液免疫与细胞免疫功能异常在儿童CAP发病过程中起重要作用,机体的免疫状况直接影响对感染的抵抗能力,细菌感染患儿的体液免疫与细胞免疫功能紊乱最为明显。
Objective: To analyze the etiological characteristics of community acquired pneumonia (CAP) in a hospital in Tangshan and to explore the correlation between community-acquired pneumonia etiology and immune status. Methods: One hundred and sixty-six patients with CAP in our hospital from January 2014 to August 2015 were enrolled in this study. Among them, 81 cases were asthmatic CAP group and 55 cases were non-asthmatic CAP group. 40 healthy children were selected as control group group. The etiological analysis of CAP children was carried out. The levels of CRP, PCT, WBC, NUET and CD_4 ~ +, CD_8 ~ + T cell level. Results: The bacterial infections were the most common in this group (40 cases, 29.41%). The main bacterial infections were Streptococcus pneumoniae (16 cases, 40.00%). The levels of CRP and PCT in CAP children were significantly higher than those in the control group The bacterial infection group had the highest CRP and PCT levels, followed by the Mycoplasma pneumoniae infection group and the mixed infection group (P <0.05). The bacterial infection group had the highest Ig G, Ig M and Ig E levels, followed by the Mycoplasma pneumoniae infection group and the mixed infection group (P <0.05). There was no significant difference in the level of Ig A between the 5 groups (F = 1.879, P = 0.265) + The lowest level, Mycoplasma pneumoniae infection group, followed by mixed infection group (P <0.05). CONCLUSION: Humoral immunity and abnormal cellular immunity plays an important role in the pathogenesis of CAP in children. The immune status of the body directly affects the resistance to infection. The humoral immunity and cellular immune dysfunction of children with bacterial infection are the most obvious.