实用临床医药杂志2026，Vol.30Issue(4)：65-71,7.DOI:10.7619/jcmp.20256306
气道黏膜免疫学特征与肺炎支原体肺炎患儿支气管黏液栓塞的关系研究
Relationship between airway mucosal immunological characteristics and bronchial mucus plug in children with Mycoplasma pneumoniae pneumonia
摘要
Abstract
Objective To explore the relationship between airway mucosal immunological charac-teristics and bronchial mucus plug(BMP)in children with Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 120 children with MPP were selected as the study subjects and divided into BMP group(BMP was found during examination,n=45)and non-BMP group(no BMP was found during examination,n=75)according to the results of bronchoscopy.Enzyme-linked immu-nosorbent assay(ELISA)was used to detect the levels of cytokines[interleukin(IL)-17A,IL-6,IL-8,IL-33,and C-X-C motif chemokine ligand 10(CXCL10)]in bronchoalveolar lavage fluid(BALF).Quantitative polymerase chain reaction(qPCR)was used to detect the expression of airway mucins(the relative mRNA expression levels of MUC5AC,MUC5B,MUC1,and MUC4).Navigation maps were drawn based on multi-slice spiral CT images,and bronchoscopy was performed on the children.The composition and α-diversity of the lower respiratory tract microbiota were analyzed by 16S rRNA gene sequencing.The hospitalization outcomes and pneumonia recurrence of the two groups of chil-dren were compared.Multivariate Logistic regression analysis was used to screen the influencing fac-tors for the occurrence of BMP.Results The levels of cytokines(IL-17A,IL-6,IL-8,IL-33,and CXCL10)in BALF were higher in the BMP group than those in the non-BMP group,and the differ-ences were statistically significant(P＜0.05).The expression levels of MUC5AC mRNA and MUC5B mRNA were higher in the BMP group than those in the non-BMP group,and the differences were statistically significant(P＜0.05);there were no significant differences in the expression lev-els of MUC1 mRNA and MUC4 mRNA between the two groups(P＞0.05).Compared with the non-BMP group,the features such as tree-in-bud sign,bronchial filling shadow,and plastic mucus plug were more significant in the BMP group during imaging and bronchoscopy,and the differences were statistically significant(P＜0.05).The microbial α-diversity in the BMP group was lower than that in the non-BMP group,and the relative abundances of Mycoplasma pneumoniae,Haemophilus influenzae,and Streptococcus pneumoniae were higher in the BMP group than those in the non-BMP group,with statistically significant differences(P＜0.05).The hospitalization duration of children in the BMP group was longer than that in the non-BMP group,the recovery rate of forced expiratory volume in one second at 90 days was lower than that in the non-BMP group,and the pneumonia re-currence rate and mechanical ventilation usage rate were higher than those in the non-BMP group,with statistically significant differences(P＜0.05).Multivariate Logistic regression analysis showed that tree-in-bud sign,high level of IL-17A,high expression of MUC5AC mRNA,and decreased α-diversity were effective predictive factors for the occurrence of BMP(P＜0.05).Conclusion The IL-17A-driven inflammatory response,over-expression of goblet cell secretory mucin MUC5AC,and decreased α-diversity of the lower respiratory tract microbiota in the airways of children with MPP are all closely related to the occurrence of BMP.关键词
肺炎支原体肺炎/儿童/支气管黏液栓塞/白细胞介素-17A/气道黏蛋白/α-多样性/支气管肺泡灌洗液/16S rRNA基因测序Key words
Mycoplasma pneumoniae pneumonia/children/bronchial mucus plug/interleukin-17A/airway mucin/α-diversity/bronchoalveolar lavage fluid/16S rRNA gene sequencing分类
医药卫生引用本文复制引用
马建军,王耀勇..气道黏膜免疫学特征与肺炎支原体肺炎患儿支气管黏液栓塞的关系研究[J].实用临床医药杂志,2026,30(4):65-71,7.基金项目
2024年度山西省卫生健康委员会科研课题计划项目(2024226) （2024226）
2024年度吕梁市科学技术局市级科技创新平台建设项目 （）
