支原体肺炎合并细菌感染患儿T细胞亚群及降钙素原检测的诊断能效

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摘要目的探讨支原体肺炎（MPP）合并细菌感染患儿T细胞亚群及降钙素原（PCT）检测的临床意义。方法选择2016年10月～2018年3月四川省简阳市人民医院（以下简称“我院”）儿科收治的MPP患儿106例，依据病原学检查结果分为单纯MPP组（41例）和细菌感染组（MPP合并细菌感染，65例），另选健康儿童50名为对照组，抽取静脉血检测PCT、C反应蛋白（CRP）、白细胞计数（WBC），采用荧光激活细胞分离仪（FACS）计数CD4+T细胞、CD8+T细胞。结果细菌感染组PCT、CRP、WBC均显著高于对照组和单纯MPP组（P ＜ 0.05），单纯MPP组CRP显著高于对照组（P ＜ 0.05）。细菌感染组和单纯MPP组CD4+T细胞显著低于对照组，细菌感染组CD4+T细胞低于单纯MPP组（P ＜ 0.05）；细菌感染组和单纯MPP组CD8+T细胞显著高于对照组（P ＜ 0.05）；细菌感染组和单纯MPP组CD4+/CD8+显著低于对照组，细菌感染组CD4+/CD8+低于单纯MPP组（P ＜ 0.05）。ROC分析：PCT及T细胞亚群指标对细菌感染的诊断价值较高，其中PCT的AUC为0.8以上。结论 MPP合并细菌感染患儿CD4+/CD8+降低、血清PCT浓度升高，T细胞亚群和PCT检测对于鉴别MPP患者有无合并细菌感染具有重要意义，结合其他辅助检查有助于早期准确判断病情，减少抗生素滥用。

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	王平康李立学张祥汪桂香

关键词 ：支原体肺炎, 细菌感染, T细胞亚群, 降钙素原

Abstract：Objective To explore the valve of detection of T cell subsets and procalcitonin (PCT) in children with Mycoplasma pneumoniae pneumonia (MPP) combined with bacterial infection. Methods A total of 106 children with MPP was recruited from October 2016 to March 2018 in Department of Pediatrics, Jianyang People′s Hospital of Sichuan Province ("our hospital" for short), and were divided into MPP group (41 cases) and bacterial infection group (MPP combined with bacterial infection, 65 cases) according to pathogeny examination, 50 cases of healthy children were recruited as control group. The blood were collected to count CD4+T cells, CD8+T cells by fluorescence activated cell sorter, and PCT, C reactive protein (CRP), white blood cell (WBC) were detected. Results PCT, CRP and WBC in bacterial infection group were significantly higher than those in control group and MPP group (P < 0.05), and CRP in MPP group was significantly higher than that in control group (P < 0.05). CD4+T cells in bacterial infection group and MPP group were significantly lower than those in control group, CD4+T cells in bacterial infection group were lower than those in MPP group (P < 0.05). CD8+T cells in bacterial infection group and MPP group were significantly higher than those in control group (P < 0.05). CD4+/CD8+ in bacterial infection group and MPP group were significantly lower than those in control group, CD4+/CD8+ in bacterial infection group was lower than that in MPP group (P < 0.05). ROC analysis showed that PCT and T cell subsets had a higher diagnostic value for bacterial infections, of which PCT AUC was more than 0.8. Conclusion CD4+/CD8+ reducted and serum PCT concentration elevated in children with MPP combined with bacterial infection. The detection of T cell subsets and PCT is of great significance in identifying whether MPP patients combined with bacterial infection. With the help of other auxiliary examinations, it can pricisely judge disease and reduce the abuse of antibiotics.

Key words： Mycoplasma pneumoniae pneumonia Bacterial infection T cell subsets Procalcitonin

基金资助:四川省卫生和计划生育委员会科研课题（15PJ0 121）。

作者简介: 王平康（1964.4-），男，主任医师；研究方向：小儿内科方面。

引用本文:

王平康李立学张祥汪桂香. 支原体肺炎合并细菌感染患儿T细胞亚群及降钙素原检测的诊断能效[J]. 中国医药导报, 2019, 16(15): 81-84.
WANG Pingkang LI Lixue ZHANG Xiang WANG Guixiang. Diagnostic energy efficiency of T cell subsets and procalcitonin in children with Mycoplasma pneumoniae pneumonia combined with bacterial infection. 中国医药导报, 2019, 16(15): 81-84.

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