Study On Cytokines In Serum And Bronchoalveolar Lavage Fluid Of Children With Refractory Mycoplasma Pneumoniae Pneumonia And Its Clinical Significance

ObjectiveThe main purpose of this study was to compare the levels of cytokines IL-4,IL-6,IFN-γ and TNF-α in serum and bronchoalveolar lavage fluid of children with refractory mycoplasma pneumoniae pneumonia.To understand the relationship between cytokines and the severity of the disease,as well as the local immune inflammatory response,and to explore the immune response involved in RMPP and the predictive value of cytokines in children with RMPP,so as to achieve early screening and diagnosis of RMPP and effectively prevent the development of the disease.MethodsAccording to the inclusion and exclusion criteria,the patients were hospitalized in the ward of Shenyang Children’s Hospital from October 2018 to October 2020.64 children who needed electronic bronchoscopy or treatment were divided into two groups according to their condition,including 32 children with MPP and 32 children with RMPP.During the acute stage of the disease(within 2 weeks),electronic bronchoscopy was performed and bronchoalveolar lavage fluid(BALF)was collected.The levels of IL-4,IL-6,IFN-γ and TNF-α in plasma and bronchoalveolar lavage fluid((BALF))were detected by flow cytometry.The clinical indexes such as CRP,FER and LDH in serum were detected.The detection indexes of the children were collected and summarized,and then SPSS22.0 was used for statistical analysis.Results1.The levels of IL-4,IL-6,IFN-γ and TNF-α in BALF of children with RMPP and MPP were significantly higher than those in plasma.2.The levels of IL-6,IFN-γ and TNF-α in BALF of children with RMPP were significantly higher than those of MPP,(P < 0.05).The levels of IL-6 and TNF-α in blood of children with);RMPP were significantly higher than those of MPP,(P < 0.05).3.There was a positive correlation between BALF and blood levels of IL-4,IFN-γ,TNF-α and IL-6 in both groups.4.The analysis of ROC curve shows that the level of TNF-α in BALF is more valuable for predicting RMPP,and the critical value is 38.78pg/ml.Conclusions1.TNF-α,IFN-γ,IL-4 and IL-6 participate in the immune response of the body,and play an important role in the occurrence and development of RMPP.2.The levels of BALF and serum TNF-α,IFN-γ,IL-4 and IL-6 were positively correlated between the two groups.3.The high expression of TNF-α in BALF is an important index for predicting RMPP,especially when TNF-α in BALF > 38.78,the risk of RMPP increases significantly with the increase of TNF-α.