肺炎支原体肺炎患儿血清白细胞介素-6及可溶性白细胞介素-6受体活性变化及意义

Serum levels of interleukin-6 and soluble interleukin-6 receptor in children with Mycoplasma pneumoniae pneumonia

摘要:

目的：为正确认识肺炎支原体肺炎(MPP)患儿免疫状态，该研究检测了MPP和非肺炎支原体肺炎患儿血清白细胞介素6(IL6)及可溶性白细胞介素6受体(sIL6R)的变化，探讨其对MPP和非MPP患儿病情的影响，并为选择合理的MPP治疗手段提供理论依据。方法：用ELISA法检测MPP患儿(n=41)及非MPP患儿(n=20)急性期和恢复期血清IL-6及sIL-6R含量。结果：①MPP 患儿血清IL-6急性期和恢复期分别为 2.01±0.41，1.12±0.67 ng/L；sIL-6R急性期和恢复期分别为 1.87±0.25，1.92±0.27 μg/L，均明显高于正常对照组 0.37±0.52 ng/L，1.71±0.15 μg/L，差异有显著性(P<0.01)；MPP患儿恢复期血清IL-6含量较急性期明显下降，差异有显著性(P<0.01)，而sIL-6R恢复期与急性期比较差异无显著性(P>0.05)；②非MPP患儿血清IL-6急性期及恢复期分别为1.56±0.26，0.84±0.63 ng/L，明显高于正常对照组，差异有显著性(P<0.01或P<0.05)，而血清sIL-6R与对照组比较差异无显著性(P>0.05)；非MPP患儿急性期血清IL-6高于恢复期，差异有显著性(P<0.05)，血清sIL-6R急性期与恢复期比较差异无显著性(P>0.05)；③MPP患儿急性期血清IL-6、sIL-6R含量较非MPP患儿急性期升高(P<0.01或P<0.05)；MPP患儿恢复期血清IL-6含量与非MPP患儿恢复期的差异无显著性(P>0.05)；MPP患儿恢复期血清sIL-6R含量明显高于非MPP患儿恢复期(P<0.01)。结论：MPP患儿血清IL-6及sIL-6R改变较非MPP患儿明显，提示MPP患儿免疫功能改变较非MPP患儿显著，IL-6及sIL-6R参与了MPP的发生和发展，有必要对MPP患儿进行免疫调节治疗。

Abstract:

OBJECTIVE: This study aims to investigate the immune state of children with Mycoplasma pneumoniae pneumonia (MPP) so as to provide evidence for determining the treatment regime of MPP. METHODS: Enzyme linked immunoassay was used to measure serum interleukin-6 (IL-6) and soluble interleukin-6 receptor (sIL-6R) levels in children with either MPP (MPP group, n=41) or bronchopneumonia with negative MP-IgM (non-MPP group, n=20). Twenty healthy children served as the Normal control group. RESULTS: Serum levels of IL-6 and sIL-6R in the MPP group were significantly higher than those of the Normal control group in both the acute and recovery stages (P< 0.01). Serum IL-6 levels of the non-MPP group in the acute and recovery stages were significantly higher than those of the Normal control group (P< 0.01, P< 0.05, respectively), while serum sIL-6R level was not different between them. In the recovery stage,serum IL-6 levels in both the MPP and non-MPP groups reduced significantly compared with those of the acute stage (P <0.01), while serum sIL-6R levels remained at a high level. The children in the MPP group had higher levels of serum IL-6 and sIL-6R in the acute stage than those of the non-MPP group (P< 0.05). In the recovery stage, the serum sIL-6R levels of the MPP group were still significantly higher than those of the non-MPP group (P< 0.01), while the difference of serum IL-6 between the two groups was not significant. CONCLUSIONS: There may be more remarkable immune function disorders in children with MPP compared to children with non-MPP. Immune regulation therapy seems to be necessary for children with MPP.