婴幼儿喘息与肺炎支原体感染的关系探讨

Association between wheezing and Mycoplasma pneumoniae infection in infants and young children

摘要:

目的 探讨婴幼儿喘息发作与肺炎支原体 （MP）感染之间的关系。方法 选取228例下呼吸道感染婴幼儿分为初次喘息组 （65例）、反复喘息组 （83例）和无喘息组 （80例）。收集患儿入院当天或次日空腹血清，采用ELISA法检测MP-IgM，化学发光法测定血清总免疫球蛋白E （TIgE），欧蒙印迹法检测血清常见过敏原特异性免疫球蛋白E （sIgE），并且收集患儿特应性体质表现及过敏性疾病家族史临床资料。结果 初次喘息组和反复喘息组患儿MP感染阳性率及血清TIgE水平高于无喘息组 （P < 0.05）；反复喘息组患儿sIgE检测阳性率显著高于初次喘息组和无喘息组 （P < 0.05），且这部分患儿特应性体质表现及过敏性疾病家族史与发病密切相关。结论 MP感染与婴幼儿喘息密切相关，MP是诱发婴幼儿喘息发作的主要病原体之一，过敏原、特应性体质和过敏性疾病家族史是婴幼儿反复喘息的主要危险因素。

Abstract:

Objective To study the association between wheezing and Mycoplasma pneumoniae (MP) infection in infants and young children. Methods A total of 228 hospitalized infants and young children who were diagnosed with lower respiratory tract infection were enrolled and classified into initial wheezing group (n=65), recurrent wheezing group (n=83), and non-wheezing group (n=80). Fasting serum was collected on the day or the second day of admission. ELISA was used to measure MP-IgM, chemiluminescence was used to measure serum total immunoglobulin E (TIgE), and EUROLine was used to measure the common serum allergen specific immunoglobulin E (sIgE). The data on the manifestations of atopic constitution and the family history of allergic diseases were collected. Results The initial wheezing group and the recurrent wheezing group showed significantly higher positive MP infection rate and serum TIgE level than the non-wheezing group (P < 0.05). The recurrent wheezing group showed a significantly higher positive rate of sIgE than the initial wheezing group and the non-wheezing group (P < 0.05), and in these patients, the manifestations of atopic constitution and the family history of allergic diseases were closed associated with the pathogenesis of wheezing. Conclusions MP infection is closely associated with wheezing in infants and young children. MP is one of the most common pathogens for wheezing in infants and young children, and the allergen sIgE, atopic constitution, and a family history of allergic diseases are important risk factors for recurrent wheezing.