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目的研究胸腺活化调节趋化因子(TARC)在儿童肺炎支原体(MP)感染致哮喘发作中的作用。方法收集肺炎患儿73例(支气管哮喘患儿除外)。在入院时(急性期)采集静脉血用被动凝集法检测MP-Ig M并用间接免疫荧光法检测其他7种呼吸病原体Ig M,并于-70℃保存部分血清;采集咽拭子用荧光定量-聚合酶链反应检测MP-DNA。根据临床诊断和MP-Ig M或MP-DNA拷贝数分为MP感染组和非MP感染组。在病情明显好转时(恢复期),对伴有哮喘发作的患儿采静脉血分离血清,置于-70℃保存。采用酶联免疫吸附试验测定患儿血清中TARC的水平。评价血清中TARC水平在两组患儿之间以及急性期和恢复期之间的差异性。结果 MP感染组患儿中有哮喘发作的比例高于非MP感染组,差异有统计学意义(χ2=4.44,P=0.04)。MP感染组患儿的TARC水平高于非感染组,差异有统计学意义(t=4.01,P=0.00)。MP感染组,有哮喘发作患儿的TARC水平高于非MP感染组有哮喘发作患儿和无哮喘发作患儿,差异有统计学意义(t=2.62,P=0.01;t=5.21,P=0.00);TARC水平无哮喘发作患儿的高于非MP感染组无哮喘发作患儿,差异有统计学意义(t=2.07,P=0.05)。MP感染组和非MP感染组,有哮喘发作患儿的TARC水平均高于无哮喘发作患儿,差异有统计学意义(t=2.11,P=0.04;t=2.03,P=0.05);有哮喘发作患儿恢复期的TARC水平较急性期均有下降,差异有统计学意义(t=4.69,P=0.00;t=2.37,P=0.05)。结论 TARC在MP感染诱发哮喘发作中起重要作用。
Objective To investigate the role of thymic activated chemokine (TARC) in the pathogenesis of asthma in children with Mycoplasma pneumoniae (MP) infection. Methods 73 cases of children with pneumonia (except for children with bronchial asthma) were collected. Venous blood was collected at admission (acute phase), MP-Ig M was detected by passive agglutination and Ig M was detected by indirect immunofluorescence in 7 other respiratory pathogens, and some serums were preserved at -70 ℃. Throat swabs were collected by fluorescence quantitative- Polymerase chain reaction detection of MP-DNA. Patients were divided into MP-infected group and non-MP-infected group according to clinical diagnosis and MP-Ig M or MP-DNA copy number. Serious improvement in the condition (recovery period), accompanied by an asthma attack in children with venous blood serum was collected and stored at -70 ℃. Serum TARC levels were measured by enzyme-linked immunosorbent assay. The difference in the level of TARC in serum between the two groups of children and between acute and convalescent phases was evaluated. Results The incidence of asthma attack in children with MP infection was higher than that in non-MP infection patients (χ2 = 4.44, P = 0.04). The level of TARC in children with MP infection was significantly higher than that in non-infected children (t = 4.01, P = 0.00). In MP infection group, the TARC level in children with asthma attack was higher than that in non-MP infection children with asthma attack and without asthma attack (t = 2.62, P = 0.01; t = 5.21, P = 0.00). There was a significant difference between children with and without TARC at onset of asthma (P> 0.05). The levels of TARC in children with and without MP infection were significantly higher than those without asthma (t = 2.11, P = 0.04; t = 2.03, P = 0.05) The level of TARC in convalescent children with asthma attack was lower than that in acute phase, the difference was statistically significant (t = 4.69, P = 0.00; t = 2.37, P = 0.05). Conclusion TARC plays an important role in MP infection-induced asthma attacks.