【摘要】 目的 探讨儿童肺炎支原体（MP）感染对机体免疫功能的影响。方法 选取2019年1月至2022年1月嘉兴市第二医院收治的儿童MP肺炎84例为研究对象，其中重症组39例，轻症组45例，另选同期本院健康体检儿童40名作为对照组。抽取3组儿童静脉血，采用乳胶增强免疫散射比浊法检测超敏C-反应蛋白（hs-CRP）水平，ELISA法检测IL-6、TNF-α水平，速率散射比浊法检测IgA、IgG、IgM水平，流式细胞仪检测CD3~+、CD4~+、CD8~+、CD4~+/CD8~+T及CD4~+CD25~+调节性T细胞（Treg）水平，Western blot法检测Toll样受体4（TLR4）/NF-κB信号通路相关蛋白表达水平；采用Pearson相关分析TLR4/NF-κB信号通路相关蛋白与炎症因子、T淋巴细胞之间的相关性。结果 重症组和轻症组患儿WBC、hs-CRP、IL-6、TNF-α、CD8~+、CD4~+CD25~+Treg水平均高于对照组，重症组患儿WBC、hs-CRP、IL-6、TNF-α、IgM、CD8~+、CD4~+CD25~+Treg水平均高于轻症组，差异均有统计学意义（均P<0.05）。重症组和轻症组患儿IgA、CD3~+、CD4~+、CD4~+/CD8~+水平均低于对照组，重症组患儿IgA、CD4~+、CD4~+/CD8~+水平均低于轻症组，差异均有统计学意义（均P<0.05）。重症组和轻症组患儿TLR4、髓样分化因子88（MyD88）、磷酸化NF-κB（pNF-κB）p65、磷酸化NF-κB抑制蛋白（p-IκB-α）水平均高于对照组，重症组患儿TLR4、MyD88、p-NF-κB p65、p-IκB-α水平均高于轻症组，差异均有统计学意义（P<0.05）。Pearson相关分析显示，TLR4/NF-κB信号通路相关蛋白TLR4、MyD88、p-NF-κB p65、p-IκB-α表达水平分别与WBC、hs-CRP、IL-6、TNF-α、CD4~+CD25~+Treg均呈正相关（均P<0.01），与CD4~+/CD8~+均呈负相关（均P<0.01）。结论 MP感染可以激活患儿机体TLR4/NF-κB信号通路，促进炎症因子释放，引起Ig变化及淋巴细胞亚群失调，且与感染的严重程度相关。更多还原

【Abstract】 Objective To investigate the effect of Mycoplasma pneumoniae（MP） infection on immune function in children. Methods Eighty-four children with MP pneumonia admitted to Jiaxing Second Hospital from January 2019 to January 2022 were enrolled, including 39 severe cases（severe group）, 45 mild cases（mild group）; and 40 healthy children served as the control group. The levels of high sensitivity C-reactive protein（hs-CRP） were detected by latex enhanced immune scattering turbidimetry, the serum levels of IL-6 and TNF-α were detected by enzyme linked immunosorbent assay（ELISA）, the levels of IgA, IgG and IgM were detected by rate nephelometry, the levels of CD3~+, CD4~+, CD8~+, CD4~+/CD8~+T 及CD4~+CD25~+Treg were detected by flow cytometry, and TLR4/NF-κB signaling pathway related proteins were detected by Western blot. Pearson correlation was used to analyze the correlation between TLR4/NF-κB signaling pathway related proteins and inflammatory factors and T lymphocytes. Results The levels of WBC, hs-CRP, IL-6, TNF-α, CD8~+, CD4~+CD25~+Treg in severe group and mild group were higher than those in control group; and the above indicators in severe group were higher than those in mild group（all P<0.05）. The levels of IgA, CD3~+, CD4~+, CD4~+/CD8~+in severe group and mild group were lower than those in control group, while the above indicators in severe group were lower than those in mild group（all P<0.05）. The levels of TLR4, MyD88, p-NF-κB p65, p-IκB-α in severe group and mild group were higher than those in control group, while the above indicators in severe group were higher than those in mild group（all P<0.05）. The expressions of TLR4/NF-κB signaling pathway related proteins were positively correlated with WBC, hs-CRP, IL-6, TNF-αand CD4~+CD25~+Treg（all P<0.01）, while negatively correlated with CD4~+/CD8~+（all P<0.01）. Conclusion MP infection can activate TLR4/NF-κB signaling pathway to promotes the release of inflammatory factors, causing the imbalance of immunoglobulin and lymphocyte subsets, which is related to the severity of MP infection in children.更多还原