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目的检测过敏性紫癜(HSP)合并肺炎支原体(MP)感染的患儿血清免疫球蛋白及补体的水平,探讨MP感染与HSP的体液免疫学关系。方法研究对象为55例HSP患儿,检测MP-IgM抗体,分为MP-IgM阳性组20例、MP-IgM阴性组35例,并以20名正常儿童作为对照组。采用全自动生化分析仪检测血清免疫球蛋白IgA、IgM、IgG、IgE及补体C3、C4。结果 HSP患儿MP感染阳性率达36.36%,合并MP感染的患儿临床症状更严重。与正常对照组相比,MP-IgM阴性组IgA、IgE明显增高(P<0.01),C3水平降低(P<0.05),同时IgE明显高于MP-IgM阳性组(P<0.01),IgG、IgM、C4无明显变化。MP-IgM阳性组与正常对照组相比,IgA增高,IgM、C3、C4水平降低,且其中IgM、C3低于MP-IgM阴性组,差异均有统计学意义(P<0.05),而IgG、IgE水平无明显改变。结论在HSP儿童中有较高MP感染率,所有HSP患儿存在血清IgA增高及C3水平降低,说明体液免疫参与HSP的发病。伴MP感染的HSP患儿体液免疫功能更加紊乱,表现在C4水平下降,IgM、C3明显低于MP-IgM阴性组,IgE增高仅见于MP-IgM阴性组,提示MP感染的HSP患儿可能更多伴有低补体血症的自身免疫紊乱参与,说明MP感染引起的免疫紊乱可能在HSP发生、发展中具有重要作用。
Objective To detect serum immunoglobulin and complement levels in children with Henoch - Schonlein purpura (HSP) infection and Mycoplasma pneumoniae (MP) infection and to investigate the relationship between MP infection and HSP humoral immunity. Methods Fifty-five children with HSP were enrolled in this study. MP-IgM antibodies were detected in 20 MP-IgM positive and 35 MP-IgM negative controls, and 20 normal children as controls. Serum immunoglobulin IgA, IgM, IgG, IgE and complement C3, C4 were detected by automatic biochemical analyzer. Results The positive rate of MP infection in children with HSP was 36.36%, and the clinical symptoms of children with MP infection were more serious. Compared with the normal control group, IgA and IgE in MP-IgM negative group were significantly increased (P <0.01), C3 level was lower (P <0.05), IgE was significantly higher in MP-IgM negative group than MP- IgM, C4 no significant change. Compared with the normal control group, IgA, C3 and C4 levels in MP-IgM positive group were significantly lower than those in normal control group (P <0.05), but IgM and C3 were lower than MP-IgM negative group , IgE levels did not change significantly. Conclusions There is a high prevalence of MP infection in HSP children. Serum IgA levels and C3 levels are decreased in all HSP children, indicating that humoral immunity is involved in the pathogenesis of HSP. The humoral immune function was more disordered in children with MP-infected HSP, the level of C4 decreased, IgM, C3 was significantly lower than MP-IgM-negative group, IgE increased only in MP-IgM-negative group, suggesting that MP-infected children with HSP may be more Participation in many autoimmune disorders accompanied by hypoactemia, indicating that immune disorders caused by MP infection may play an important role in the occurrence and development of HSP.