儿童肺炎支原体肺炎凝血功能和免疫功能相关指标水平变化及其临床意义

魏娜

[摘要] 目的 探討儿童肺炎支原体肺炎凝血功能和免疫功能相关指标水平变化及其临床意义。 方法 选取江苏省张家港市中医医院（以下简称“我院”）2013年1月～2015年6月收治的80例肺炎支原体肺炎患儿为研究对象，其中间质肺炎45例为间质肺炎组，大叶肺炎35例为大叶肺炎组；选择同期在我院进行体检儿童40例作为对照组，分别检测三组凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶原活动度（PTA）、凝血酶时间（TT）、凝血酶原比值（INR）、纤维蛋白原（FIB）、D-二聚体（D-D）、补体C3、补体C4、IgM、IgG、IgA、CD4+水平。 结果 间质肺炎组和大叶肺炎组PT、APTT、补体C3、补体C4、IgM、IgG、IgA、CD4+水平均显著低于对照组（P < 0.01），FIB、D-D水平均显著高于对照组（P < 0.01）。间质肺炎组FIB、D-D、IgA、补体C3水平均低于大叶肺炎组（P < 0.05），IgM、补体C4水平均高于大叶肺炎组（P < 0.05）；间质肺炎组和大叶肺炎组其余指标比较，差异无统计学意义（P > 0.05）。 结论 肺炎支原体肺炎患儿存在不同程度凝血功能异常，免疫功能紊乱现象，故临床检测患儿凝血功能及免疫功能相关指标能够为临床诊断及治疗提供重要依据。

[关键词] 肺炎支原体肺炎；凝血功能；免疫功能；意义

[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210（2016）11（b）-0094-04

[Abstract] Objective To explore the changes and clinical significance of related index levels of blood coagulation function and immune function in children with Mycoplasma pneumoniae pneumonia. Methods 80 cases of children with Mycoplasma pneumoniae pneumonia in Traditional Chinese Medicine Hospital of Zhangjiagang City， Jiangsu Province （"our hospital" for short ） from January 2013 to June 2015 were selected as study objects， 45 cases of children were selected as interstitial pneumonia group， 35 cases of children were selected as lobar pneumonia group， 40 cases of healthy children who had physical examination during the same period in our hospital were selected as control group. The indexes levels of prothrombin time （PT）， activated partial thromboplastin time （APTT）， prothrombin activity （PTA）， thrombin time （TT）， prothrombin time ratio （INR）， fibrinogen （FIB）， D-Dimer （D-D）， complement C3， complement C4 and IgM， IgG， IgA， CD4+ were detected among three groups. Results PT， APTT， complement C3， complement C4， IgM， IgG， IgA， CD4+ levels in interstitial pneumonia group and lobar pneumonia group were significantly lower than those in control group （P < 0.01）. FIB and D-D levels in interstitial pneumonia group and lobar pneumonia group were significantly higher than those in control group （P < 0.01）. FIB， D-D， IgA， complement C3 levels in interstitial pneumonia group were lower than those in lobar pneumonia group （P < 0.05）. IgM， complement C4 levels in interstitial pneumonia group were higher than those in lobar pneumonia group （P < 0.05）. There were no statistical differences in the levels of other indexes between interstitial pneumonia group and lobar pneumonia group （P > 0.05）. Conclusion There are varying degrees of coagulation function abnormal， immune function disorder in children with Mycoplasma pneumoniae pneumonia， so the related indexes of coagulation and immune function in clinical detection can provide important basis for clinical diagnosis and treatment of children.

[Key words] Mycoplasma pneumoniae pneumonia； Blood coagulation function； Immune function； Significance

支原体感染是小儿呼吸道感染的常见病原体，呼吸道飞沫传播是该病原体主要传播途径，可导致支原体流行性或散发性呼吸道感染[1]。据流行病学调查显示，当前支原体感染性肺炎发病率显著提升，年龄愈来愈小，且肺外并发症呈现多样化，成为小儿呼吸道感染的重要病原体[2]。支原体感染性小儿肺炎可导致患儿凝血系统及免疫功能紊乱，使其抵抗力下降，危害其身体正常发育。掌握肺炎支原体肺炎患儿凝血功能及免疫功能相关指标变化可为临床病情判断、治疗等提供依据。……