Study Of Cytokines And Chest Chest High-resolution CT, Pulmonary Function On Children Patients With Mycoplasma Pneumoniae Pneumonia

Objective To investigate the correlation analysis between children patients with Mycoplasma pneumoniae pneumonia and cytokine Mycoplasma pneumoniae infection. To evaluate the relationship between cellular cytokine levels(IL-15 and IL-17) and mycoplasma pneumonia pneumonia in children patients.Methods 52 cases of MPP children staying Taian Central Hospital of Shandong Province were selected as the experimental group, including 23 cases of severe patients and 29 cases of mild patients. Additionally, 38 cases of healthy children were added to the control group. The serum IL-15, IL-17 were measured using enzyme-linked immunosorbent assay. The serum IL-15, IL-17 levels were compared among severe group, mild group and control group; The serum IL-15, IL-17 levels were compared between acute and group; severe group and mild group of acute and convalescent serum IL-15, IL-17 levels.Results(1) compared with mild MPP and healthy, serum IL-17 and IL-15 levels in the severe MPP were increased significantly(P <0.05), and serum IL-17 and IL-15 levels in the mild MPP were significantly higher than the healthy(P <0.05) in the acute stage and recovery stage of mycoplasma pneumonia;(2) for severe patients group, serum IL-17 and IL-15 levels in acute stage were significantly higher than the recovery stage(P <0.05);(3) The levels of serum IL-17 and IL-15 during acute period of severe group were significantly higher than those of the recovery group(P <0.05);(4)analysis of the relationship between the expression of serum IL-17 and IL-15 levels of MPP patients suggests no apparete correlation in the acute stages and weak correlation in the recovery stage.Conclusion(1)The incidence of the severity of the MPP as IL-15 IL-17 level rise and increases, both of which can be used as the MPP judge the severity reference index.(2) analysis of the relationship between the expression of serum IL-17 and IL-15 levels of MPP patients suggests no apparete correlation in the acute stages and weak correlation in the recovery stage.Objective(1)To summarize the clinical characteristics of mycoplasma pneumonia(MPP) in school-age children.(2) To investigate the chest high-resolution CT(HRCT) characters and their relationship with pulmonary function changes of MPP in school-age children.Methods Sixty-seven MPP children at school age hospitalized in the Department of Pediatric in Tai’an Central Hospital from June, 2015 to January, 2013 were selected and observed according to their clinical stag. We record(1) the clinical symptoms, and the occurrence rate, times and duration of some pathological signs(2) Their chest HRCT and pulmonary function at acute phase, the second different stages and third review period respectively. The lesion’s distribution and morphological characteristics of chest HRCT images were reviewed by professional physicians. And the lungs, pleura, mediastinum situation of pulmonary were also assessed. The pulmonary function tests included forced vital capacity(FVC), 1 second forced expiratory volume(FEV1), peak expiratory flow(PEF), forced expiratory flow at 25% of FVC(FEF25), forced expiratory forced vital capacity of 50% when gas flow(FEF50), forced expiratory flow(FEF75) and forced expiratory flow rate medium-term(MMEF75 / 25) 75% when the FVC percent predicted values. These parameters mentioned above were statistically analyzed to determine the correlation between the variation of chest HRCT and lung ventilation function of MPP in school-age children.Results(1) MPP clinical symptoms of school-age children include fever, cough, and sore throat, accounted for 94.0%, 89.5%, and 67.2% respectively. The first onset symptom is fever, usually occurred at 1.48 ± 0.5 days after onset; the longest symptom is cough, lasting 12.59 ± 3.7days. MPP of school-age children are usually lack of pulmonary signs at early stage, in some cases there may have transient wheezing or crackles in the lung, sometimes associated with extra-pulmonary symptoms.(2) School-age children MPP patients show varying degrees of ventilatory dysfunction mainly are obstructive ventilatory dysfunctions. a: Compared acute group with the second phase group, there was a significant difference of all the lung functions(P value less than 0.05); b: Between the acute group and the third phase groups, the lung function were significant differences(P<0.01); c: There is also a significant difference, of pulmonary function between Phase II review group and third review groups(p<0.01).(3) Chest HRCT findings in school-age children MPP patients present diversity. In acute group, lesions often involve multiple lobes more than a single lobe; in the second and third review groups, usually single lobe lesions involved. In all the three groups, the right lower pulmonary lobe is predominantly involved. The most common change is the increase of pulmonary markings(24/55, 43.63%), the following change is large opacities(23/55, 41.8%) and atelectasis(15/55, 27.27%). The secondary review group shows variable degree of absorption, of which 42.00% lesions(21/50) are completely absorbed. In the third review group, 59.26% lesions(16/27) are completely absorbed; but among them still 11 cases shows variable degrees of image changes.(4) According to the HRCT findings, the patients were divided into groups with bronchial pneumonia, segmental pneumonia, or lobar pneumonia. All the patients have different levels of pulmonary dysfunction. Bronchial pneumonia group showed obstructive ventilatory dysfunction, with airway ventilation dysfunctions. Segmental pneumonia and lobar pneumonia showed mixed ventilation dysfunction, all the pulmonary function indexes(actual / pre-<80%) indicate small airway obstructive ventilatory dysfunctions, the pulmonary function between this two group is no significant difference(P> 0.05). In the second review group, HRCT findings still show(actual/pre-<80%) in the normal appearing patients,that suggests the recovery of small airway function are slowly.Conclusion(1)The preminet MPP clinical of school-age children are fever,cough,and sore throat and lacking of positive signs.(2)The recovery time of lung HRCT and pulmonary function are longer than that of clinical symptoms.(3) School-age children MPP chest HRCT findings are diversity, but have some regularity.(4) There are variable degrees of small airways dysfunction occurred in school-age children MPP; the ventilator dysfunctions are prominently involved.(5) The vary changes of pulmonary dysfunction in school-age children MPP correlated with the severity of the lung HRCT changes. In MPP, both the large and small airways are injury, but in the segmental pneumonia and lobar pneumonia, the small airways are prominently involved and the recovery is slow.(6) Lung HRCT and pulmonary function MPP school-age children determine can be used as a marker to evaluate the severity and also can be used as an important indicator of prognosis.