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目的:通过动物实验和临床分析,从组织病理学、免疫学角度初步探讨肺炎支原体(MP)感染时血清循环免疫复合物(CIC)水平的改变及其在支原体肺炎(MPP)及肺外损伤发病机制中的作用。方法:动物实验部分,用MP菌株滴鼻建立小鼠MPP动物模型,将小鼠随机分为低剂量感染组、高剂量感染组和正常对照组,综合肺匀浆病原学检测及肺组织病理改变结果鉴定模型,动态监测各组小鼠心、肝、肾、脑等各脏器病理改变及聚乙二醇沉淀试验法检测血清CIC;临床调查部分,统计临床资料,将患儿分为单纯MPP组、合并肺外表现组、健康对照组,检测MPP急性期、恢复期血清CIC。结果:①动物实验方面,MP感染后高剂量感染组小鼠血清CIC明显增高,肺炎病理改变最重及有肺外表现时CIC最高。②临床调查方面,MPP患儿急性期血清CIC与健康对照组比较明显增高,合并肺外表现患儿与单纯MPP患儿肺炎急性期血清CIC比较,差异有统计学意义(P<0.05)。结论:血清CIC可能在MPP肺外表现发生体液免疫机制中起到重要作用,MPP有自限性。
OBJECTIVE: To investigate the changes of serum circulating immune complex (CIC) level in Mycoplasma pneumoniae (MP) infection and the pathogenesis of mycoplasma pneumonia (MPP) and extrapulmonary injury from the aspects of histopathology and immunology through animal experiments and clinical analysis. Mechanism of the role. Methods: In the part of animal experiment, animal model of MPP was established by intranasal instillation with MP strain. The mice were randomly divided into low dose infection group, high dose infection group and normal control group. The pathological changes of pulmonary homogenate Results The model was established to detect the pathological changes of heart, liver, kidney, brain and other organs in vivo and to detect serum CIC by polyethylene glycol precipitation test. The clinical investigation and clinical data were divided into three groups: pure MPP Group, combined with extrapulmonary manifestations group, healthy control group, detection of MPP acute and convalescent serum CIC. Results: ① In animal experiments, the serum CIC of mice infected with high dose of MP was significantly higher than that of the mice infected with MP, the pathological changes of pneumonia were the heaviest, and the CIC was the highest when there was extrapulmonary manifestations. ② In clinical investigation, serum CIC in acute phase of MPP was significantly higher than that in healthy control group. There was significant difference in serum CIC between acute pulmonary edema and acute pulmonary encephalomyelitis in children with MPP (P <0.05). CONCLUSION: Serum CIC may play an important role in the humoral immune mechanism of extrapulmonary MPP, and self-limiting MPP.