The Infection Status Of Mycoplasma Pneumoniae Pneumonia In The Children Of Lai Wu Area And The Detection Result Of Immunologic Function In Children Patients

Mycoplasma pneumoniae(MP) is one of the common cause ofcommunity-acquired pneumonia(CAP) in children and other respiratory tractinfections. According to the statistical analysis both at home and abroad,susceptible age for mycoplasma pneumoniae pneumonia (MPP) is5to15yearsold, but infants and the elderly can also be infected. The incidence of MPPbecomes from10%to30%. The epidemic outbreak period throughout the worldis from2to6years, and the incidence of the disease even can be as high as50%during the epidemic period. The susceptible season of MPP is autumn and earlywinter. Its clinical features are stubborn cough, and the disease can causedamage to heart, liver and kidney as well as central nervous system and otherviscera.The disease can cause a variety of extra-pulmonary complications. Inrecent10years, the onset of mycoplasma pneumoniae pneumonia has presentedthe following features: early age, a significant rise in the incidence of childrenwith MPP under five years old, and an increase of severe and refractorymycoplasma pneumonia mycoplasma pneumonia year by year, which feasuressevere state of illness, accompanied by multiple organ function damage,insensitive to drugs, bad treatment effect, protracted course of disease, and evenendangers the life or legacy different degree sequela. Seen from the above,mycoplasma pneumoniae pneumonia, a common and frequently-occurringdisease, has a serious impact on children’s physical and mental health. As aresult, it has become a spiritual and economic burden to their families andsociety. So it is of great importance and necessity that much clinical workshould be done, including a timely understanding of morbidity situation ofmycoplasma pneumoniae pneumonia and its related influencing factors, a timely and effectively control of the happening of the disease and its spread.Meanwhile, it is also crucial to have a comprehensive understanding of thepathogenesis of mycoplasma pneumoniae pneumonia, make a definitivediagnosis of mycoplasma pneumoniae pneumonia and give appropriate treatment.Mycoplasma pneumoniae is caused by pathogenic microorganisms, anindependent living minimal prokaryotic type of pathogenic microorganismsbetween bacteria and viruses, which has no cell wall with morphologicaldiversity, and can pass the bacteria filter. So far, it is not very clear about itspathogenic mechanism. At present, there are two main academic point ofviews about pathogenic mechanism of mycoplasma pneumoniae. Some scholarshold that mycoplasma pneumoniae can go directly into airway epithelial cellsand causes direct damages and also causes the immune damages after itsinvasion into the immune response. In recent years, some scholars have foundthat MP can directly release toxins, causing damage to the respiratory epithelialcells and its apoptosis. Of all the current discussions about the pathogenesis ofmycoplasma pneumoniae, the research of immunological mechanism remains theprevelent. Many studies have shown that mycoplasma pneumoniae infection cancause a variety of cytokines and the change of humoral immune function, etc.ObjectivesThis thesis aims to investigate and make an analysis of MPP incidence andits trendency in the children of Laiwu area in2012, explores the related impactfactors and studies children serum interleukin-2(IL-2), interleukin-8(IL-8),interleukin-10(IL-10), soluble intercellular adhesion molecule-1(sICAM-1),immunoglobulins and its clinical significance, hoping to provide a theoreticalbasis for more timely and effective control of MPP epidemic outbreak andtreatment in the future.Methodology1. The author chose1128pneumonia patients as examples from the childrenin pediatric wards and outpatient diagnosis as CAP in the Maternal and ChildHealth Hospital of Laiwu City in Shandong Province from January1,2012toDecember31,2012. Children were diagnosed as patients with MPP if their antiMP-IgM was positive by using Passive Agglutination Method to determinate theresistance to mycoplasma pneumoniae antibody in serum of children (MP-IgM).Meanwhile, detailed records were made of children patients’ gender, age, living environment, time of onset, and the number of sick etc.2. Immune function detetion of the children patients with mycoplasmapneumonia: choosing50patients from the diagnosed MPP children in theMaternal and Child Health Hospital of Laiwu City in Shandong Province fromJanuary2012to January2013, including30patients of MPP group,20patientsof severe MPP group; at the same time, selecting30healthy children who weretaken physical examination in our hospital as a control group, usingenzyme-linked immunosorbent assay method carried IL-2, IL-8, IL-10,sICAM-determination; using the approach of single immunodiffusion methodfor the determination of serum immunoglobulin (Ig).Results1. Mycoplasma pneumoniae pneumonia in epidemiological situation in LaiWu Area.(1)Among the1128with pneumonia detected MP-IgM,396cases werepositive, with the positive rate as high as35.1%.(2) The rate of boy MPP incidence was34.18%, while that of girls MPPincidence was36.67%, showing no statistically significance.(3) MPP appeared in four seasons of the year2012, but the incidence in thefirst and second quarters was significantly higher than the third and fourthquarters.(4) MPP incidence was different in different age groups, with the highestamong children at the age4-6and7-9.(5) The findings of Lung X-ray revealed that children with lobarpneumonia had a higher rate of MP infection than children with bronchialpneumonia and interstitial pneumonia.(6) The rate of MPP incidence in urban children was40.8%, while the ratein rural children was30.9%. The rate of MPP incidence in the urban children issignificantly higher than that in rural children.2. The detection results of Immune function in MPP children(1) Serum IL-2, IL-10levels in acute phase of MPP patients wassignificantly lower than the control group, the level of IL-8was higher than thatof the control group, the difference was statistically significant (P<0.01). Whilein the recovery phase, Serum IL-2decreased rapidly, IL-10levels incresedcompared with the control group, the difference was statistically significant (P <0.01). Th levels of IL-2, IL-10and IL-8were statistically significant in thecute phase and the recovery phase (P <0.01). Compared with the ordinary MPP,severe MPP concentrations of serum IL-2and IL-10decreased moresignificantly, IL-8content increased more significantly, and the difference wassignificant (P <0.05).(2) Compared with the control group, the level of serum sICAM-1inpatients with MPP was significantly higher in acute stage, the difference wasstatistically significant (P <0.01), while in the recovery period, it decreasedrapidly and the difference was not statistically significant (P>0.05). The serumsICAM-1of severe MPP group was significantly higher than that of ordinaryMPP group, and the difference was significant (P <0.05).(3) Compared with the control group, serum IgA and IgM in MPP childrenincreased significantly both in acute phase and in recovery phase, and thedifference was statistically significant (P <0.05). In the recovery phase, serumIgG increased significantly, compared with the control group, the difference wasstatistically significant (P <0.05). MPP in children with severe group IgA, IgGand IgM increased obviously and the difference was statistically significant (P<0.05).Conclusion1. Situation of the incidence of mycoplasma pneumoniae pneumoniaIn2012, Mycoplasma pneumoniae infection in children accounted for35.1%of children with pneumonia community-acquired in Lai Wu;Mycoplasma pneumoniae pneumonia occurred throughout the year of2012inLai Wu, but the first and second quarters were considered as the peak seasons ofoutbreak of MPP; mycoplasma pneumoniae incidence of pneumonia is unrelatedto sex; children from0to12years old can probabley get MPP, with the childrenat the age4-6and7-9having the highest incidence. Different environmentsaffected the incidence of pneumonia mycoplasma pneumonia and urban city hada higher rate of incidence than rural areas. Lobar pneumonia in children wascaused by the infection of mycoplasma pneumoniae. These findings providetheoretical basis for the clinical staff and related departments to carry out amore timely control of the incidence and spread of MPP in children.2. Relations between Inflammatory cytokines and Mycoplasma pneumoniae There were significant changes in pneumonia of children suffering frompneumonia mycoplasma pneumonia serum IL-2, IL-8, IL-10, sICAM-1, andMycoplasma pneumoniae pneumonia illness, indicating that Mycoplasmapneumoniae infection when the body is obviously including cytokines and otherinflammatory factors, including immune dysfunction.3. Relations between Immunoglobulin with Mycoplasma pneumoniaepneumoniaSerum levels of immunoglobulin IgA, IgG, IgM changed significantly inChildren with MPP and and were related with the severity of MPP, indicatingthat humoral immunity involved in the pathogenesis of MPP and MP infectionmay induce disturbance of humoral immunity.