肺炎支原体肺炎患儿TNF-α、IFN-γ 和IL-4 细胞因子水平的变化

Changes of TNF-α, IFN-γ and IL-4 levels in children with Mycoplasma pneumonia pneumonia

摘要:

目的 研究儿童肺炎支原体肺炎（MPP）血清及肺泡灌洗液（BALF）中细胞因子肿瘤坏死因子- α（TNF-α）、γ 干扰素（IFN-γ）和白细胞介素-4（IL-4）的表达，以进一步研究MPP 的发病机制。 方法 选取行纤维支气管镜介入治疗的90 例MPP 患儿作为MPP 组，依据病程分为MPP1 组（<7 d）、MPP2 组 （7 ～ 14 d）和MPP3 组（15 ～ 30 d），每组30 例。对照组为同期非MPP 且需经纤维支气管镜检查或治疗的患儿。 留取血清和BALF 进行相关细胞因子测定。结果 MPP 组患儿血清TNF-α、IFN-γ 和IL-4 水平较对照组 升高（P <0.05）；MPP1 组TNF-α 和IFN-γ 水平最高（P <0.05），MPP2 组细胞因子IL-4 水平最高（P <0.05）。 MPP 组患儿BALF 中TNF-α、IFN-γ 和IL-4 水平高于对照组（P <0.05）；MPP1 组TNF-α、IFN-γ 升 高最明显（P <0.05），MPP2 组IL-4 水平最高（P <0.05）。直线相关分析结果显示，血清与BALF 中炎症因子 表达有相关性（r =0.939、0.958 和0.912，均P =0.000）。结论 细胞因子TNF-α、IFN-γ 和IL-4 在MPP 患儿血清及肺泡灌洗液中升高，病程<7 d 以细胞因子TNF-α、IFN-γ 升高为主，病程7 ～ 14d 以细胞因 子IL-4 升高为主，提示细胞因子在MPP 的发展过程中可能有重要意义。

Abstract:

Objective To analyze the levels of TNF-α, IFN-γ and IL-4 in serum and bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumonia pneumonia (MPP). Methods The data of 90 patients with MPP who were admitted to Tianjin Children's Hospital from January 2017 to December 2017 were collected. The patients were randomly divided into MPP1 group (<7 d), MPP2 group (7-14 d) and MPP3 group (15-30 d) according to the course of disease on admission with 30 cases in each group. The control group was non-MPP children who were having fiberoptic bronchoscopy. The levels of cytokines (TNF-α, IFN-γ and IL-4) were detected by ELISA. Results The serum levels of TNF-α, IFN-γ and IL-4 increased significantly in the MPP patients compared with the controls (P < 0.05); the serum expression levels of TNF-α and IFN-γ were the highest in the MPP1 group (P < 0.05), while the serum level of IL-4 was the highest in the MPP2 group (P < 0.05). The levels of cytokines (TNF-α, IFN-γ and IL-4) in BALF increased significantly in the MPP groups compared with the control group (P < 0.05); the increase of TNF-α and IFN-γ levels was the most obvious in the MPP1 group (P < 0.05), and the level of IL-4 was the highest in the MPP2 group (P < 0.05). The expressions of cytokines in serum had obvious correlations with those in BALF by linear correlation analysis (TNF-α, r = 0.939; IFN-γ, r = 0.958; IL-4, r = 0.912). Conclusions The levels of TNF-α, IFN-γ and IL-4 significantly increase in serum and BALF of children with MPP, and the expressions of TNF-α and IFN-γ are the highest in the children with the disease course <7 days. In the course of 7-14 days, IL-4 is elevated significantly. Our data suggested that these cytokines may be involved in the pathogenesis of Mycoplasmal pneumonia pneumonia.