Changes Of T Lymphocyte Subsets,IL-4,IL-22 And TNF-? Levels In Alveolar Lavage Fluid Of Children With Mycoplasma Pneumoniae Pneumonia

Mycoplasma pneumoniae(MP)is one of the most common pathogens of respiratory tract infections in children.The literature reports that the global infection rate is as high as 66.7%and is increasing year by year.The vast majority of Mycoplasma pneumoniae pneumonia(MPP)has a good prognosis,but some children may also progress to severe MPP with extrapulmonary disease(encephalitis,hemolyticanemia,Kawasakidisease),left bronchiectasis,and obliterative fineness.Bronchitis and other diseases reduce the children's quality of life.The incidence of severe MPP increases year by year.Its early identification and treatment are of great significance for blocking the progression of severe MPP and improving prognosis.Objective:By studying the changes of T lymphocyte subsets,IL-4,IL-22and TNF-?levels in bronchoalveolar lavage fluid of children with MPP,it provides a theoretical basis for the early diagnosis and treatment of severe MPP.Methods:1.To collect 102 children with MPP admitted to our department of pedia-trics from January 2017 to December 2017 and 15 children with bronchial foreign bodies.2.All subjects underwent bronchoscopy and alveolar lavage for bronc-hoalveolar lavage fluid.3.According to the severity of pneumonia,they were divided into severe MPP group,normal MPP group,and control group.4.Flow cytometry was used to detect CD3~+T,CD4~+T,CD8~+T,and CD4~+T/CD8~+T in bronchoalveolar lavage fluid.5.The levels of IL-4,IL-22 and TNF-?in bronchoalveolar lavage fluid were measured by ELISA and analyzed statistically.Results:1.The proportion of preschool-age and school-age children with severe MPP was significantly higher than that of infants,and there was no significant difference between preschool and school age.2.There was no statistically significant difference in WBC and PLT between the groups;the expression of NLR,CRP,and LDH in peripheral blood increased and the expression of PA decreased.The difference between the severe group and the normal group was statistically significant.3.Compared with the control group,the expression of CD4+T and CD4+T/CD8+T in the bronchoalveolar lavage fluid of children with MPP decreased;the expression of CD8+T increased,and the difference between the severe group and the normal group was statistically significant.4.Compared with the control group,the levels of cytokines IL-4,IL-22and TNF-?in the bronchoalveolar lavage fluid of children with MPP increased,and the difference between the severe group and the normal group was statis-tically significant.Conclusions:1.Preschool and school-age children may be risk factors for severe MPP.2.The levels of NLR,CRP,LDH,PA in the peripheral blood are related to the severity of MPP,which has important guiding significance for the evaluation of MPP condition.3.The expression of CD4+T,CD4+T/CD8+T in the bronchoalveolar lavage fluid of children with MPP was decreased,and the expression of CD8+T was elevated,suggesting the presence of immune disorders.As the disease progresses,the immune dysfunction becomes more obvious and the immuno-modulatory treatment Instructive.4.The levels of IL-4,IL-22,and TNF-?in the bronchoalveolar lavage fluid of children with MPP are elevated,and are related to the severity of MPP,and have clinical diagnostic value for severe MPP.