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4、日期:2022 11 25)DOI:10 3969/j issn 1671 4695 2023 07 018文章编号:1671 4695(2023)07 0738 05不同病原体感染重症肺炎患儿T 细胞亚群、炎症因子水平差异及临床特征分析金欣1邓明惠2丁波1艾爱3*(三二一医院1 儿科;2 微免科陕西汉中723000;3 榆林市第一医院儿科陕西榆林719000)基金项目:陕西省科技厅科研基金资助项目(编号:2018489)*通讯作者:艾爱，E mail:jinxin150828126 com【摘要】目的分析不同病原体感染重症肺炎(SP)患儿 T 细胞亚群、炎症因子水平差异及临床特征。方法回顾性
5、分析 2019 年 1 月至 2021 年 1 月期间三二一医院收治的 160 例重症肺炎患儿，收集所有患儿的临床资料，分析不同病原体感染的患儿血清高敏 C 反应蛋白(hs CP)和降钙素原以及 T 淋巴细胞亚群的表达水平差异;比较不同性别、不同季节之间患儿细菌和病毒的检出情况。结果病原体检出阳性率为 90 62%，其中病毒检出最多(101 株，5771%)，其次为支原体(41 株，23 43%)，其余为细菌(33 株，18 86%)。3 组不同病原体感染患儿血清 hs CP 和降钙素原的表达水平相比，差异有统计学意义(P 0 05);细菌和支原体感染患儿血清 hs CP 的表达水平显著高于病
6、毒感染患儿，支原体感染患儿血清降钙素原的表达水平显著高于细菌和病毒感染患儿。不同病原体感染患儿之间 CD3+和 CD4+T 细胞亚群水平比较，差异无统计学意义(P 0 05);细菌和支原体感染患儿 CD8+T 细胞水平显著高于病毒感染患儿，差异有统计学意义(P 0 05)。不同性别的患儿在细菌和病毒检出率方面差异无统计学意义(P 0 05);而女性患儿支原体的检出率显著高于男性患儿，差异有统计学意义(P 0 05)。细菌和支原体在 3 6 岁患儿中检出率最高(40 00%和 41 82%)，病毒在 0 1 岁患儿中检出率最高(82 35%)。不同季节之间细菌和病毒的检出率比较，差异无统计学意义
7、(P 0 05)，而支原体在夏季的检出率最高。不同病原体感染患儿之间出现发热、寒战、呼吸困难、湿啰音以及喘鸣音等临床表现的发生率比较，差异无统计学意义(P 0 05)，而支原体患儿发生咳嗽的占比显著高于细菌和病毒感染患儿，细菌感染患儿胸痛的发生率显著高于支原体和病毒感染患儿，差异有统计学意义(P 0 05)。结论不同病原体感染所致重症肺炎患儿的临床特征、T 细胞亚群和血清炎症因子水平的表达水平有所差异，结合多项指标和临床特征可早期鉴别诊断细菌、支原体或病毒感染，为临床及早干预提供一定的帮助。【关键词】病原体重症肺炎临床特征T 细胞亚群炎症因子Analysis of levels of T ce
8、ll subset，inflammatory factors and clinical features of children with severe pneumonia infected by differentpathogens JIN Xin1，DENG Ming hui2，DING Bo1，et al 1 Department of Pediatrics，2 Department of Immunology，3201 Hospital，HanzhongShaanxi 723000，China【Abstract】ObjectiveTo analyse the levels of T c
9、ell subset，inflammatory factors and clinical features of children with severe pneumonia(SP)infected by different pathogens Methodsetrospective selected 160 children with SP admitted to Hanzhong 3201 Hospital Affiliated to Xian Jiaotong University School of Medicine from January 2019 to January 2021，
10、the clinical data of all children were collected，differences in the ex-pression levels of serum high sensitivity C reactive protein(hs CP)，procalcitonin，and T lymphocyte subsets in children infected withdifferent pathogens were analyzed The detection of bacteria and viruses in children of different
11、sexes and seasons was compared esultsThepositive rate of pathogen detection was 90 62%，of which virus was the most(101 stocks，5771%)，mycoplasma was the second(41 stocks，23 43%)，and then was bacteria(33 stocks，18 86%)The expression levels of serum hs CP and procalcitonin of three group was different，
12、the difference was statistically significant(P 005);the hs CP of bacteria and mycoplasma group were higher than virus group;the procalci-tonin of mycoplasma group was higher than bacteria and virus group The levels of CD3+and CD4+T cell subset were not different(P 005);the CD8+of bacteria and mycopl
13、asma group were higher than that in the virus group，the differences were statistically significant(P 0 05)The detection rates of bacteria and virus between different sexuality were not different(P 0 05);while the detection rate of mycoplasma ofgirls was higher than boys，the difference was statistica
14、lly significant(P 0 05)The highest detection rates of bacteria and mycoplasma were837Journal of Clinical and Experimental Medicine Vol22，No7Apr2023during 3 6 years old(40 00%and 41 82%)，the highest detection rate of virus was during 0 1 years old The detection rates of bacteria andvirus between diff
15、erent seasons were not different(P 005)，while the highest detection rate of mycoplasma was at summer The incidence ratesof fever，chills，breathing difficulties，moist rales and wheezing among different different pathogens had no difference(P 005)，while the inci-dence rate of cough of mycoplasma group
16、was higher than bacteria and virus，and the incidence rate of chest pain of bacteria group was higher thanmycoplasma and virus group，the difference was statistically significant(P 005)ConclusionThe clinical features，levels of T cell subsetand inflammatory factors of children with SP infected by different pathogens were significantly different，combination of multiple indicators can earlydifferential diagnosis of bacteria，mycoplasma and virus，which can provide certain help for early clinical interv