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目的正确了解支原体肺炎儿童血清中TNF-α、IL-6、IL-8和IL-10浓度的临床研究及诊断意义。方法采用双抗体夹心ELISA法测定支原体肺炎儿童78例(病例组)和健康儿童78例(对照组)两组儿童血清中TNF-α、IL-6、IL-8和IL-10浓度,观察两组儿童血清中各种免疫因子浓度变化及变化时临床表现。结果 1肺炎支原体感染儿童血清中TNF-α、IL-6、IL-8和IL-10浓度较健康儿童大幅度升高,差异具有统计学意义(P<0.05);免疫因子浓度在一定范围内决定了肺炎的严重程度;给予适宜治疗后,测得儿童血清中因子浓度与治疗前相比下降幅度大,但略高于健康儿童,差异不明显,无统计学意义(P>0.05)。2肺炎儿童有胸腔积液的经胸片检查发现肺部有纤维化改变的儿童血清及胸腔积液的因子浓度与无纤维化改变儿童比较,因子浓度大幅度增高,差异具有统计学意义(P<0.05);肺部无纤维化病变的儿童血清与胸腔积液中因子浓度接近,差异不明显,数据无统计学意义(P>0.05)。结论儿童支原体肺炎主要由于肺炎支原体侵入人体引起免疫系统激活并大量产生释放TNF-α、IL-6、IL-8和IL-10等免疫因子所致,且这些免疫因子与肺部是否发生纤维化病变有关,因此血清中各免疫因子的浓度变化是确诊儿童支原体肺炎发展的主要依据。
Objective To understand the clinical significance and diagnostic significance of serum levels of TNF-α, IL-6, IL-8 and IL-10 in children with mycoplasma pneumonia. Methods Serum levels of TNF-α, IL-6, IL-8 and IL-10 in 78 children with mycoplasma pneumonia and 78 healthy children in the control group were measured by double antibody sandwich ELISA. Serum levels of various immunosuppressive agents in children and clinical manifestations at the change. Results The serum levels of TNF-α, IL-6, IL-8 and IL-10 in children with Mycoplasma pneumoniae infection were significantly higher than those in healthy children (P <0.05). The concentration of immune factors was within a certain range The severity of pneumonia was decided. After the appropriate treatment, the serum concentration of the factor in children was decreased by a large margin compared with that before treatment, but it was slightly higher than that in healthy children. The difference was not statistically significant (P> 0.05). 2 pneumonia children with pleural effusion of chest X-ray examination found that the changes of lung fibrosis in children with serum and pleural effusion factor concentration compared with children without changes in fibrosis, the factor concentration increased significantly, the difference was statistically significant (P <0.05). There was no significant difference between the serum levels and pleural effusion in children without fibrosis (P> 0.05). Conclusion Mycoplasma pneumonia in children is mainly caused by the invading immune system in Mycoplasma pneumoniae and the release of immune factors such as TNF-α, IL-6, IL-8 and IL-10. And these immune factors are related to the occurrence of pulmonary fibrosis Pathological changes, so the concentration of serum immune factors in the diagnosis of children with Mycoplasma pneumonia is the main basis for the development.