重症肺炎支原体肺炎与血清IgE和C反应蛋白水平的相关性及临床特征

doi:10.3969/j.issn.1004-583X.2023.05.008

摘要/Abstract

摘要：

目的探讨重症肺炎支原体肺炎(SMPP)与血清IgE和C反应蛋白(CRP)水平的相关性及临床特征。方法回顾性分析2021年7月至2022年5月承德市中心医院儿科收治的153例MPP患儿临床资料,其中SMPP患儿84例,非SMPP患儿69例。分析比较SMPP患儿与非SMPP患儿临床特征、实验室检查结果、肺部影像学特征,确定患者血清IgE和CRP水平与SMPP严重程度的相关性。结果 SMPP组热程、住院时间长于非SMPP组,差异有统计学意义(P<0.05);SMPP组肺部出现并发症的比例高于非SMPP组,差异有统计学意义(P<0.05)。SMPP组中性粒细胞百分数、中性粒细胞与淋巴粒细胞比值、血清IgE水平、CRP水平高于非SMPP组,淋巴细胞百分数低于非SMPP组,差异有统计学意义(P<0.05)。SMPP组肺部影像表现为大片实变影的患儿比例高于非SMPP组,差异有统计学意义(P<0.05)。IgE、CRP水平与重症肺炎呈正相关,IgE、CRP水平升高是是发生SMPP的独立危险因素(P<0.05)。结论血清IgE和CRP是重症支原体肺炎的独立危险因素且对 SMPP 的早期识别具有重要意义。

关键词: 重症肺炎, 肺炎支原体, 免疫球蛋白E, C反应蛋白

Abstract:

Objective To investigate the correlations between serum severe mycoplasma pneumoniae pneumonia (SMPP)levels with immunoglobulin E (IgE) and C-reactive protein (CRP) in children. Methods A total of 153 children with MPP hospitalized in the Department of Pediatrics of NO.2 Clinical Teaching Hospital, Chengde Medical University from July 2021 to May 2022 were enrolled in this retrospective study, including 84 SMPP and 69 non-SMPP. Clinical characteristics, laboratory examination results and pulmonary imaging features were compared between SMPP children and non-SMPP children. Meanwhile, the correlation between serum levels of IgE and CRP with the severity of SMPP in patients was determined. Results SMPP children had longer duration of fever and hospitalization duration than non-SMPP children, and the differences were statistically significant (P<0.05). The proportion of pulmonary complications in SMPP children was significantly higher than that in non-SMPP children (P<0.05). The percentage of neutrophil, the ratio of neutrophil/lymphocyte, and serum levels of IgE and CRP in SMPP children were significantly higher than those in non-SMPP children (P<0.05). However, the percentage of lymphocytes in SMPP children was remarkably lower (P<0.05). The proportion of SMPP children with large consolidation shadows on pulmonary imaging was obviously higher than that in non-SMPP children (P<0.05). IgE and CRP levels were positively correlated with SMPP, and elevated levels of IgE and CRP were independent risk factors for SMPP occurrence (P<0.05). Conclusion Serum IgE and CRP are independent risk factors for SMPP, which are of great significance for early identification of SMPP.

Key words: severe pneumonia, mycoplasma pneumoniae, immunoglobulin E, C-reactive protein

中图分类号:

R725.6

程婷婷, 齐彩英, 张雪莲, 肖梦, 隋伟行, 李小燕, 刘建英. 重症肺炎支原体肺炎与血清IgE和C反应蛋白水平的相关性及临床特征[J]. 临床荟萃, 2023, 38(5): 433-437.

Cheng Tingting, Qi Caiying, Zhang Xuelian, Xiao Meng, Sui Weihang, Li Xiaoyan, Liu Jianying. Analysis of correlations between serum severe mycoplasma pneumoniae pneumonia level with immunoglobulin E and C-reactive protein in children[J]. Clinical Focus, 2023, 38(5): 433-437.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.05.008

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I5/433

图/表 7

参考文献 24

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项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z/χ²值	P值
年龄[岁,M(P25,P75)]	6.0(3,8)	2.0(1,4)	5.250	<0.01
发热[例(%)]	76(90)	57(83)	1.557	0.115
咳嗽[例(%)]	83(99)	68(99)	0.140	0.889
喘息[例(%)]	8(10)	8(12)	0.173	0.677
肺部并发症[例(%)]	16(19)	0	5.145	0.023
热程[d,M(P25,P75)]	7(5,10)	5(3,7)	3.381	<0.01
住院天数[d,M(P25,P75)]	9(7,12)	6(5,7)	6.642	<0.01

项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z/χ²值	P值
年龄[岁,M(P25,P75)]	6.0(3,8)	2.0(1,4)	5.250	<0.01
发热[例(%)]	76(90)	57(83)	1.557	0.115
咳嗽[例(%)]	83(99)	68(99)	0.140	0.889
喘息[例(%)]	8(10)	8(12)	0.173	0.677
肺部并发症[例(%)]	16(19)	0	5.145	0.023
热程[d,M(P25,P75)]	7(5,10)	5(3,7)	3.381	<0.01
住院天数[d,M(P25,P75)]	9(7,12)	6(5,7)	6.642	<0.01

项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z值	P值
白细胞计数(×10⁹/L)	7.1(5.8,9.2)	7.6(5.9,9.9)	0.981	0.327
中性粒细胞(%)	59.6(53.1,64.8)	49.6(34.2,64.1)	3.079	0.002
淋巴细胞(%)	29.9(26.1,36.5)	40.2(27.5,52.4)	3.078	0.002
中性粒细胞/淋巴细胞(%)	2.0(1.5,2.5)	1.3(0.6,2.3)	3.018	0.003
血红蛋白 (g/L)	128(120.0,135.0)	126(115.0,133. 0)	1.495	0.135
血小板(×10⁹/L)	242(191.0,283.0)	264(206.0,343.0)	1.701	0.089
乳酸脱氢酶(U/L)	267(225.0,323.0)	260(231.0,299.0)	0.945	0.345
IgE(IU/ml)	91.5(50.2,168.5)	40.15(13.2,141.3)	3.254	<0.01
CRP (mg/L)	16.5(8.0,49.8)	10(1.0,24.0)	3.693	<0.01

项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z值	P值
白细胞计数(×10⁹/L)	7.1(5.8,9.2)	7.6(5.9,9.9)	0.981	0.327
中性粒细胞(%)	59.6(53.1,64.8)	49.6(34.2,64.1)	3.079	0.002
淋巴细胞(%)	29.9(26.1,36.5)	40.2(27.5,52.4)	3.078	0.002
中性粒细胞/淋巴细胞(%)	2.0(1.5,2.5)	1.3(0.6,2.3)	3.018	0.003
血红蛋白 (g/L)	128(120.0,135.0)	126(115.0,133. 0)	1.495	0.135
血小板(×10⁹/L)	242(191.0,283.0)	264(206.0,343.0)	1.701	0.089
乳酸脱氢酶(U/L)	267(225.0,323.0)	260(231.0,299.0)	0.945	0.345
IgE(IU/ml)	91.5(50.2,168.5)	40.15(13.2,141.3)	3.254	<0.01
CRP (mg/L)	16.5(8.0,49.8)	10(1.0,24.0)	3.693	<0.01

组别	例数	点片状阴影、斑片状阴影	大片实变影
SMPP组	84	25(30)	59(70)
非SMPP组	69	69(100)	0
χ²值		78.883
P值		<0.01