Glucocorticoid in the assistance treatment of pediatric mycoplasma pneumonia

YAN Hui; ZHANG Hui-yu; LI Hong; YUE Ai-hong; TIAN Ling

doi:10.3760/cma.j.issn.1673-4777.2013.07.020

Abstract：Objective To evaluate the changes of immunoglobulin and T lymphocyte subsets in mycoplasma pneumonia (MPP) with glucocorticoid.Methods All 420 children with MPP were enrolled and randomly divided into two groups:glucocorticoid group and non-glucocorticoid group,with 210 cases in each group.Moreover,the glucocorticoid group was treated with methylprednisolone via intravenous drip [1-2 mg/(kg · d)] and budesonide via atomizing inhalation for 3-5 days.The non-ghcocorticoid group was remained untreated.In addition,30 healthy children were included as normal control group.The changes of immunoglobulin and T lymphocyte subsets were observed.Results Before treatment,the percentages of CD3+,CD4+,CD8+ T cells,the ratio of CD4+/CDs+ T cells and the IgA,IgG and IgM levels in glucocorticoid group were (32 ± 11)％,(29 ± 11)％,(31 ± 17)％,(1.0 ±0.3)％,(1.7 ±0.5) g/L,(13.4 ± 1.7) g/L,(1.8 ±0.4)g/L respectively.While the data was (32 ±11)％,(29 ±11)％,(32 ±18)％,(0.9 ±0.6)％,(1.8 ±0.3)g/L,(12.4 ±l.5)g/L,(1.9 ±0.2)g/L in nonglucocorticoid group,and (62 ±21)％,(40 ±5)％,(22 ±32)％,(1.7 ±0.6)％,(1.2 ±0.8) g/L,(9.3 ±2.6) g/L,(1.3 ± 0.6) g/L in normal control group.All those indexes in glucocorticoid group and non-glucocorticoid group had statistical differences (P ＜ 0.05).After treatment,CD3+ 、CD4+/CD8+ [CD3+:(47 ± 9) ％ vs (39 ±9)％,CD4+/CD8+:(1.8 ±0.5) vs(1.2 ±0.5),P ＜0.01].The CD8+ was lower[(18 ±7) ％ contrast with(28 ±8) ％,P ＜0.01].There were no statistical differences of IgA、IgG and IgM between glucocorticoid group and nonglucocorticoid group (P ＞ 0.05).Conclusions The immune response in the children with MPP is depressed,and the humoral immunity is in disorder.Small dose of glucocorticoid can effectivdy regulate the immune function.