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. 2019 Sep;21(9):876-880.
doi: 10.7499/j.issn.1008-8830.2019.09.006.

[Correlation between Mycoplasma pneumoniae DNA replication level and disease severity in children with severe Mycoplasma pneumoniae pneumonia]

[Article in Chinese]
Ke-Nan Fang  1 , Jing Wang, Jing-Wen Ni
Affiliations

[Correlation between Mycoplasma pneumoniae DNA replication level and disease severity in children with severe Mycoplasma pneumoniae pneumonia]

[Article in Chinese]
Ke-Nan Fang et al. Zhongguo Dang Dai Er Ke Za Zhi. 2019 Sep.

Abstract
in English, Chinese

Objective: To study the correlation of Mycoplasma pneumoniae DNA (MP-DNA) replication level in throat swab and bronchoalveolar lavage fluid (BALF) with disease severity in children with severe Mycoplasma pneumoniae pneumonia (SMPP).

Methods: A total of 44 children with SMPP who underwent bronchoalveolar lavage were enrolled as subjects. The serum levels of cytokines and MP-DNA replication times in throat swab were measured in the acute stage and the recovery stage, and the levels of interleukin (IL)-8 and MP-DNA replication times in BALF were measured in the acute stage. According to whether mechanical ventilation was needed for respiratory failure, the children were divided into a mechanical ventilation group (n=19) and a non-mechanical ventilation group (n=25), and the two groups were compared in MP-DNA replication times in BALF.

Results: For the children with SMPP, serum levels of C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase, IL-1, IL-6, IL-8, and IL-18 in the acute stage were significantly higher than those in the recovery stage (P<0.05). In the acute stage, MP-DNA replication times in throat swab were positively correlated with those in BALF (r=0.613, P<0.05), and MP-DNA replication times in BALF were positively correlated with IL-18 levels in peripheral blood and BALF (r=0.613 and 0.41 respectively, P<0.05). Compared with the non-mechanical ventilation group, the mechanical ventilation group had significantly higher MP-DNA replication times in BALF, a significantly longer duration of systemic hormone treatment, significantly higher serum levels of lactate dehydrogenase and IL-18, and significantly higher white blood cell count and IL-18 level in BALF (P<0.05).

Conclusions: In children with SMPP, MP-DNA replication level in throat swab and BALF can be used as a reference index for the assessment of disease severity.

目的: 探讨重症肺炎支原体肺炎（SMPP）患儿咽拭子、肺泡灌洗液（BALF）中肺炎支原体DNA（MP-DNA）复制水平与病情的相关性。

方法: 44例行支气管肺泡灌洗术的SMPP患儿为研究对象，分别在急性期和恢复期检测相关血清细胞因子水平及咽拭子MP-DNA复制倍数，并检测急性期BALF中白细胞介素（IL）-18水平及MP-DNA复制倍数。并按照病程中是否出现呼吸衰竭需要机械通气分为机械通气组（n=19）与非机械通气组（n=25），比较两组患儿肺泡灌洗液中MP-DNA复制倍数。

结果: 与恢复期相比，SMPP患儿在急性期时，血清C反应蛋白、红细胞沉降率、乳酸脱氢酶、IL-1、IL-6、IL-8、IL-18水平显著增高（P < 0.05）。急性期咽拭子与BALF的MP-DNA复制倍数呈显著正相关（r=0.613，P < 0.05）；BALF中MP-DNA复制倍数与外周血及BALF的IL-18水平呈正相关（分别r=0.613、0.41，均P < 0.05）。机械通气组BALF中MP-DNA复制倍数高于非机械通气组，且全身激素治疗时间明显长于非机械通气组，血清乳酸脱氢酶、IL-18及BALF中WBC总数、IL-18水平也更高（P < 0.05）。

结论: SMPP患儿急性期咽拭子与BALF MP-DNA复制水平可作为病情评估的参考。

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Figures

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急性期咽拭子与肺泡灌洗液的MP-DNA复制倍数的相关性
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急性期血清IL-18与灌洗液MP-DNA复制倍数的相关性
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急性期灌洗液IL-18与MP-DNA复制倍数的相关性
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