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目的观察肺炎支原体肺炎(MPP)患儿中枢神经系统(CNS)损害情况,并探讨其机制。方法收集2007年1月-2009年3月本院收治的MPP患儿325例,观察合并CNS损害的症状和体征,对有CNS损害的患儿进一步检测其血清和脑脊液中IL-8、IL-18和可溶性白细胞介素-2受体(sIL-2R)水平。以同期住院的病毒性脑炎患儿作为对照组。采用SPSS12.0软件进行统计学分析。结果325例MPP患儿中,22例(6.8%)出现CNS损害,主要表现为发热、呕吐、头痛和惊厥。MPP并CNS损害患儿血清和脑脊液中IL-8、IL-18和sIL-2R水平明显高于对照组,特别是脑脊液中IL-18和sIL-2R水平(Pa<0.01)。MPP并CNS损害患儿血清和脑脊液中IL-18与sIL-2R均呈正相关(Pa<0.01)。结论MPP合并CNS损害患儿血清和脑脊液中IL-18和sIL-2R水平明显升高,可能与肺炎支原体导致CNS损害的发生有关。
Objective To investigate the damage of central nervous system (CNS) in children with Mycoplasma pneumoniae pneumonia (MPP) and to explore its mechanism. Methods 325 patients with MPP in our hospital from January 2007 to March 2009 were collected. The symptoms and signs of CNS injury were observed. The children with CNS injury were further tested for IL-8 and IL- 18 and soluble interleukin-2 receptor (sIL-2R) levels. In the same period of hospitalized children with viral encephalitis as a control group. SPSS12.0 software was used for statistical analysis. Results Of 325 children with MPP, 22 (6.8%) had CNS damage, mainly manifested as fever, vomiting, headache and convulsion. The levels of IL-8, IL-18 and sIL-2R in serum and cerebrospinal fluid of children with MPP and CNS injury were significantly higher than that of the control group, especially the levels of IL-18 and sIL-2R in cerebrospinal fluid (Pa <0.01). There was a positive correlation between IL-18 and sIL-2R in serum and cerebrospinal fluid in children with MPP and CNS damage (Pa <0.01). Conclusion The levels of IL-18 and sIL-2R in serum and cerebrospinal fluid of children with MPP combined with CNS damage are significantly increased, which may be related to the pathogenesis of CNS damage caused by Mycoplasma pneumoniae.