【摘要】 目的探讨肺炎支原体肺炎(MPP)患儿血清和支气管肺泡灌洗液(BALF)中肺表面活性蛋白(SP)-A、SP-D和Toll样受体2(TLR2)水平变化及相关性。方法选择2015年7月至2017年7月珠海市人民医院儿科收治的确诊为MPP并行支气管肺泡灌洗术患儿35例,根据疾病情况将患儿分为MPP组(n=23)和难治性肺炎支原体肺炎(RMPP)组(n=12),另选择同期行支气管镜异物取出术且未合并明显肺部感染患儿10例作为对照组。采用酶联免疫吸附试验检测3组患儿血清和支气管肺泡灌洗液(BALF)中SP-A、SP-D和TLR2的水平,并分析血清与BALF中SP-A、SP-D和TLR2的相关性。结果 RMPP组和MPP组患儿BALF和血清中SP-A、SP-D、TLR2水平均高于对照组(P<0.05);RMPP组患儿BALF中TLR2水平高于MPP组(P<0.05),2组患者血清和BALF中SP-A、SP-D水平比较差异均无统计学意义(P>0.05)。血清与BALF中的TRL2水平呈中等相关(r=0.459,P<0.05),而血清与BALF中的SP-A、SP-D水平无显著相关性(r=0.223、0.175,P>0.05)。结论 SP-A、SP-D和TLR2可能在MPP的发病机制中起到重要作用,MPP患儿血清与BALF中的TRL2水平呈正相关,监测MPP患儿血清TLR2水平变化可为临床诊断肺部炎症提供依据。更多还原

【Abstract】 Objective To study the changes and relationship of pulmonary surfactant protein(SP)-A,SP-D and Tolllike receptor 2(TLR2) in serum and bronchoalveolar lavage fluids(BALF) in children with mycoplasma pneumoniae pneumonia(MPP). Methods Thirty-five children with MPP and underwent bronchoscopy in Department of Pediatrics,the People’s Hospital of Zhuhai from July 2015 to July 2017 were selected as subjects and all children were divided into MPP group(n = 23)and refractory mycoplasma pneumoniae pneumonia(RMPP) group(n = 12) according to the condition of disease. At the same time,ten children who underwent operation of removal of foreign body by bronchoscopy and with no obvious pulmonary infection were selected as control group. The levels of SP-A,SP-D and TLR2 in serum and BALF were detected by enzyme linked immunosorbent assay and the correlation of variables including SP-A,SP-D and TLR2 in serum and BALF was analysed. Results The levels of SP-A,SP-D and TLR2 in serum and BALF of patients in MPP group and RMPP group were significantly higher than that in the control group(P < 0. 05); the level of TLR2 in serum and BALF of patients in the RMPP group was significantly higher than that in the MPP group(P < 0. 05); there was no statistic difference in the levels of SP-A and SP-D in serum and BALF of patients between the MPP group and RMPP group(P > 0. 05). The level of TRL2 in serum was moderately correlated with the level of TRL2 in BALF(r = 0. 459,P < 0. 05),and the levels of serum SP-A and SP-D were not correlated with the levels of SP-A and SP-D in BALF(r = 0. 223,0. 175; P > 0. 05). Conclusion SP-A,SP-D and TLR2 may play an important role in the pathogenesis of MPP. The level of TRL2 in serum of children with MPP is positively correlated with the level of TRL2 in BALF. The monitoring of the change of serum TLR2 level in children with MPP can provide the evidence for clinical diagnosis of pulmonary inflammation.更多还原