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目的 探究不同血清乳酸脱氢酶(lactate dehydrogenase, LDH)水平肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia, MPP)患儿临床特征及其与细胞免疫相关性。方法 选取2019年6月至2023年6月在北京市大兴区人民医院就诊的MPP患儿350例为研究对象，根据病情病情程度将其分为轻症组(n=118)、重症组(n=120)和危重症组(n=112)。分析不同血清LDH水平与MPP病情程度的独立相关性，按LDH水平从低到高等分为五分位数组(Q1～Q5)，进行LDH水平与细胞免疫的相关性的亚组分析，并进行血清LDH水平影响因素的分层回归分析。结果 LDH水平与MPP的病情程度存在独立相关性。在临床因素分层分析中，血清LDH水平与MPP病情程度的相关性稳定存在。在高免疫球蛋白(immunoglobulin,Ig)G、IgM、IgA水平下，随着LDH水平升高，MPP的发生风险升高；在低CD3+T细胞、低CD8+T细胞、低CD4+T细胞、低CD45+T细胞、CD16+56+自然杀伤细胞(natural killer, NK)细胞、CD19+T细胞及CD4+/CD8+水平下，随着LDH水平升高，MPP的发生风险升高，LDH与IgG、IgM、IgA、CD3+T细胞、CD8+T细胞、CD4+T细胞、CD45+T细胞、CD16+56+NK细胞、CD19+T细胞水平及CD4+/CD8+具有且明显交互作用(P交互<0.05)。无论男性还是女性，随着LDH增高，重度MPP的发生风险均呈先增高后平稳的趋势。结论 LDH水平随着MPP病情程度增加而升高。LDH水平与IgG、IgM、IgA水平存在显著正相关关系；与CD3+T细胞、CD8+T细胞、CD4+T细胞、CD45+T细胞、CD16+56+NK细胞、CD19+T细胞水平及CD4+/CD8+存在显著负相关关系，可作为评估MPP发展及患儿免疫功能评估的重要指标。
Abstract：Objective To investigate the clinical characteristics of children with Mycoplasma pneumoniae pneumonia(MPP at different serum lactate dehydrogenase(LDH) levels and their correlation with cellular immunity. Methods Three hundred and fifty children with MPP who visited our hospital from June 2019 to June 2023 were selected and divided into mild group(n=118), severe group(n=120), and critical group(n=112) based on the severity of their condition. Analyze the independent correlation between different serum LDH levels and the severity of Mycoplasma pneumoniae pneumonia, and divide them into quintiles(Q1-Q5) based on LDH levels from low to high. Perform subgroup analysis on the correlation between LDH levels and cellular immunity, and conduct stratified regression analysis on the influencing factors of serum LDH levels. Results There is an independent correlation between LDH levels and the severity of MPP. In the stratified analysis of clinical factors, there is a stable correlation between serum LDH levels and the severity of MPP disease.At high levels of IgG, IgM, and IgA, as LDH levels increase, the risk of MPP increases; At low levels of CD3+ T cells, CD8+ T cells, CD4+T cells, CD45+ T cells, CD16+56+ NK cells, CD19+ T cells, and CD4+/CD8+, as LDH levels increase, the risk of MPP increases. LDH has a significant interaction with IgG, IgM, IgA, CD3+ T cells, CD8+ T cells, CD4+ T cells, CD45+ T cells, CD16+56+ NK cells, CD19+ T cells, and CD4+/CD8+ levels(P<0.05). The risk of severe MPP increases first and then stabilizes with the increase of LDH in both males and females.Conclusions LDH levels increase with the severity of Mycoplasma pneumoniae pneumonia. LDH levels are significantly positively correlated with IgG, IgM, and IgA, and negatively correlated with CD3+ T cells, CD8+ T cells, CD4+ T cells, CD45+ T cells, CD16+56+ NK cells, CD19+ T cells, and CD4+/CD8+ lymphocyte counts. LDH levels can be used as an important indicator for evaluating the development of MPP and evaluating the immune function of children.
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基本信息:
DOI：
中图分类号:R725.6
引用信息:
[1]陈清华,王婧文,王慧琳.不同血清乳酸脱氢酶水平肺炎支原体肺炎患儿临床特征及其与免疫功能相关性[J].传染病信息,2025,38(03):256-262+288.
基金信息: