| Objective: Detection of refractory mycoplasma pneumoniae pneumonia(RMPP)and common pneumonia mycoplasma pneumonia(GMPP)in children with peripheral blood and bronchoalveolar lavage fluid(BALF)of the communist party of China to stimulate molecular sB7-H1 and IL-10,TGF-β,IL-17 expression level,and comparing with clinical data,analysis of correlation,provide the basis for early recognition and forecasting the occurrence of RMPP.Methods: Children with Mycoplasma pneumoniae pneumonia(MPP)hospitalized in our hospital from October 2018 to October 2020 were selected.The children were both positive for Mycoplasma pneumoniae Ig M(MP-Ig M)and positive for MP-DNA detected by polymerase chain reaction(PCR).The experimental group was divided into RMPP group(n=30)and GMPP group(n=30).The control group was children(n=20)with bronchial foreign body removed due to bronchial foreign body.Using enzyme-linked immunosorbent assay(ELISA)in the experimental group was detected in children children with acute stage,recovery,and the control group in the peripheral blood and bronchoalveolar lavage fluid sB7-H1,IL-10,the expression of TGF-β and IL-17 levels,at the same time accurate records with clinical data,including: age,gender,fever days,white blood cell count,neutrophils ratio,lactate dehydrogenase,c-reactive protein and merger pleural effusion,atelectasis,pulmonary consolidation,extrapulmonary complications,etc,and statistical analysis.Results:1.The expression levels of sB7-H1,IL-10 and TGF-β in serum and BALF of GMPP group in acute stage were significantly higher than those in recovery stage,and the expression level of IL-17 was lower than that in recovery stage,with statistical significance(P< 0.05).2.The expression levels of sB7-H1,IL-10 and TGF-β in serum and BALF of RMPP group in acute stage were significantly higher than those in recovery stage,and the expression level of IL-17 was lower than that in recovery stage,with statistical significance(P< 0.05).3.The expression levels of sB7-H1,IL-10 and TGF-β in serum and BALF of RMPP group in acute period were significantly higher than those of GMPP group in acute period and control group,and the expression level of IL-17 was lower than that of control group,the difference was statistically significant(P<0.05);There was no significant difference in the expression of IL-17 in serum and BALF of RMPP group and GMPP group during the acute period(P>0.05).4.The expression levels of sB7-H1 and IL-10 in serum of GMPP group in the acute period were significantly higher than those in the control group,and the expression level of IL-17 was lower than that in the control group,with statistical significance(P<0.05);There was no significant difference in TGF-β expression between the control group and the control group(P>0.05);The expression levels of sB7-H1 and TGF-β in BALF of GMPP group at the acute stage were significantly higher than those of the control group,and the expression level of IL-17 was lower than that of the control group,with statistical significance(P<0.05);The expression level of IL-10 in BALF of GMPP group at acute stage was not significantly different from that of control group(P>0.05).5.There were no significant differences in the expression levels of sB7-H1,IL-10,TGF-β and IL-17 in serum and BALF between RMPP group and GMPP group during the recovery period(P>0.05).6.Correlation analysis of the expression level of sB7-H1 in serum and BALF of GMPP group in acute period showed a significant positive correlation(r=0.866,P< 0.05).7.Correlation analysis of the expression level of sB7-H1 in serum and BALF in RMPP group in acute period showed a significant positive correlation(r=0.768,P<0.05).8.There was no correlation between sB7-H1 and IL-10,TGF-β and IL-17 in serum and BALF of GMPP group at the acute stage(P>0.05).9.There was a significant positive correlation between sB7-H1 and IL-10 in serum and BALF of RMPP group at the acute stage(serum: r=0.681,P<0.05;BALF: r=0.622,P<0.05),but had no correlation with TGF-β and IL-17(P>0.05).10.The expression level of sB7-H1 in MPP group was correlated with fever days,white blood cell count,neutrophil ratio,CRP,LDH,combined pleural effusion,lung consolidation,atelectasis and combined liver damage(P<0.05),Moreover,the expression of sB7-H1 was higher in fever days≥7 days,WBC≥10.0*109/L,NE≥0.6,CRP≥30mg/L,LDH≥385 IU/L,combined with pleural effusion,lung consolidation,atelectasis,and combined with liver damage.The expression of sB7-H1 was taken as the dependent variable,and the 9 clinical indicators related to sB7-H1 were taken as the independent variables for linear regression analysis: CRP,LDH,pleural effusion and lung consolidation were the independent influencing factors of serum sB7-H1 expression in the acute stage(P<0.05).11.The expression of sB7-H1 in BALF of MPP group was correlated with fever days,neutrophil ratio,CRP,LDH,pleural effusion,pulmonary consolidation and atelectasis(P<0.05).The expression of sB7-H1 was higher in fever days≥7days,NE≥0.6,CRP ≥ 30mg/L,LDH ≥ 385IU/L,combined with pleural effusion,pulmonary consolidation,and atelectasis.The expression of sB7-H1 was taken as the dependent variable and the 7 clinical indicators related to sB7-H1 were taken as the independent variables for linear regression analysis:CRP and lung consolidation were independent influencing factors affecting the expression of sB7-H1 in BALF at the acute stage(P<0.05).Conclusion:1.The expression levels of sB7-H1,IL-10 and TGF-β in serum and BALF were significantly increased in RMPP group and GMPP group at the acute stage,and the expression level in RMPP group was significantly higher than that in GMPP group at the acute stage.The expression levels of sB7-H1,IL-10 and TGF-β in RMPP group and GMPP group at acute stage were significantly higher than those in RMPP group and GMPP group at recovery stage.The expression level of IL-17 in serum and BALF of RMPP group and GMPP group in the acute period was lower than that of RMPP group and GMPP group in the recovery period.There was a significant positive correlation between the expression level of sB7-H1 in serum and BALF in RMPP group at the acute stage.sB7-H1,IL-10,TGF-β and IL-17 may be involved in the pathogenesis of MPP,especially RMPP,through excessive immune inflammation and mediated Th17/Treg imbalance.2.The expression level of sB7-H1 in serum and BALF of RMPP group at the acute stage was positively correlated with IL-10,which was correlated with clinical data.Through linear regression analysis,it is found that: CRP,LDH,pleural effusion and lung consolidation were independent influencing factors of serum sB7-H1 expression in acute stage.CRP and lung consolidation were independent factors affecting the expression level of sB7-H1 in BALF at the acute stage.sB7-H1 may play a role in the pathogenesis of RMPP.Detection of the expression level of sB7-H1 in serum and BALF has certain clinical significance for early recognition and prediction of the occurrence of RMPP. |
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