Study On The Significance Of Cytokine In Bronchoalveolar Lavage Fluid In Children With Refractory Mycoplasma Pneumoniae Pneumonia And The Correlation With Serum C Reactive Protein

Objective: Objective to explore the levels and clinical significance of MCP-4,IL-25,TNF-alpha and Cys LTR-1 in bronchoalveolar lavage fluid(BALF)of children with refractory Mycoplasma pneumoniae pneumonia(RMPP),and analyze their correlation with serum C reactive protein.Method:Methods from March 2016 to December 2017,109 children diagnosed as refractory Mycoplasma pneumoniae pneumonia and underwent fiberoptic bronchoscopy in the acute phase were selected as the experimental group.According to its bronchoscopy,it was divided into 68 cases of group RMPP1 and 41 cases in group RMPP2.According to whether the children were accompanied by wheezing,20 cases were divided into RMPP1 accompanied by wheezing group,48 cases without wheezing group,15 cases of RMPP2 accompanied by wheezing group and 26 cases in RMPP2 without wheezing group.15 cases of lobar pneumonia with non Mycoplasma pneumoniae and no wheezing were selected in the same period(15 cases in control group),and 15 children in the same period were taken out of bronchial foreign body(control group 2).The clinical significance of MCP-4,IL-25,TNF-alpha and Cys LTR-1 in the alveolar lavage fluid of the experimental group was determined by double antibody sandwich ELISA.Result:1.The levels of CRP,DD,ALT and N% in the RMPP1 group with severe bronchoscopy were higher than those in the RMPP2 group with relatively light bronchoscopy.2.RMPP group RMPP1 with wheezing 4 cytokine mean(117.8)is higher than the other five groups mean(P all <0.05),RMPP2 with wheezing 4cytokine mean(85.79)is higher than RMPP2 without wheezing,NMPP group and FB group mean(P <0.05).There was no statistical difference in the 22 of the other groups(P >0.05).CRP was positively correlated with IL-25,TNF-alpha and MCP-4,and had no significant correlation with Cys LTR-1Conclusion:1.The clinical laboratory indexes of RMPP1 group with severe bronchoscopy were CRP,DD,ALT and N% higher than those of RMPP2 group.The above laboratory indexes could assist RMPP recognition early,and the higher the above indicators,the heavier the performance of RMPP.2.cytokines MCP-4,IL-25,Cys LTR-1 and TNF-alpha are all involved in the pathogenesis of RMPP,and play an important role in the occurrence and aggravation of asthma in children induced by MP infection.3.The level of CRP in serum and bronchoalveolar lavage fluid IL-25,MCP-4 and TNF-a levels were correlated,MCP-4 and IL-25 are caused by selective effects of Th2 immune inflammatory damage mediated by Th2 cells and CRP associated with IL-25 and MCP-4,suggesting that CRP may also be affected by Th2 cells which can cause immune inflammatory damage mediated by Th2 cells.