Changes in cellular classification levels in bronchoalveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia
Objective To investigate the changes in cell classification levels in bronchoalveolar lavage fluid(BALF)of children diagnosed with Mycoplasma pneumoniae pneumonia(MPP).Methods This study was a prospective cohort study.During the period spanning January to June 2022,a cohort of 30 children diagnosed with acute MPP who were admitted to the Department of Pediatrics and Pediatric Intensive Care Unit(PICU)at the First Affiliated Hospital of Xinxiang Medical University and underwent bronchoalveolar lavage were enrolled as the study group.Concurrently,9 children presenting with uncomplicated bronchial foreign bodies were recruited as the control group.In the study group,there were 15 boys and 15 girls,aged(6.6±2.5)years.In the control group,there were 6 boys and 3 girls,aged(5.7±5.4)years.Wright-Giemsa stain coupled with microscopic examination served as the analytical tools to scrutinize alterations in the proportion of BALF cell classifiications in children and their potential association with extrapulmonary manifestations.x2 test,independent sample t test,and rank sum test were used.Results The levels of neutrophil percentage,C-reactive protein,D-dimer,and lactate dehydrogenase in blood routine of the study group were higher than those of the control group[71.05(56.40,79.83)％vs.46.50(34.50,62.45)％,17.47(4.86,37.65)mg/L vs.1.00(0.17,1.64)mg/L,1.75(0.80,4.23)mg/L vs.0.60(0.55,0.75)mg/L,342(269,482)U/L vs.245(181,284)U/L],while the percentage of lymphocytes in blood routine was lower than that of the control group[23.45(13.55,34.95)％vs.43.20(33.10,58.55)％],with statistically significant differences(all P＜0.05).The percentage of BALF neutrophils in the study group was higher than that in the control group[46.00(38.00,55.00)％vs.1.00(0.01,1.75)％],while the percentage of macrophages was lower than that in the control group[43.00(33.87,51.00)％vs.87.50(85.00,90.00)％],with statistically significant differences(both P＜0.05).According to the presence or absence of extrapulmonary manifestations,the study group was divided into 23 cases without extrapulmonary manifestations and 7 cases with extrapulmonary manifestations(2 cases with kidney damage,liver damage,and myocardial damage,3 cases with kidney damage and myocardial damage,1 case with kidney damage,and 1 case with myocardial damage).The levels of calcitonin,serum amyloid A,lactate dehydrogenase and aspartate aminotransferase in the group with extrapulmonary manifestations were higher than those in the group without extrapulmonary manifestations[0.74(0.42,3.59)μg/L vs.0.35(0.19,0.68)μg/L,464.9(172.8,655.6)mg/L vs.134.9(41.0,431.0)mg/L,697.0(469.0,1 177.0)U/L vs.296.0(255.0,417.0)U/L,54.0(42.0,109.0)U/L vs.30.0(22.0,37.0)U/L],the length of hospital stay was longer than that in the group without extrapulmonary manifestations[19.00(18.00,22.00)d vs.11.00(7.00,16.00)d],and the percentage of BALF lymphocytes and albumin level were lower than those in the group without extrapulmonary manifestations[10.50(9.50,11.00)％vs.13.00(10.00,14.50)％,33.9(27.3,40.2)g/L vs.40.3(37.1,42.3)g/L],with statistically significant differences(all P＜0.05).Spearman correlation analysis showed that the percentage of BALF lymphocytes was negatively correlated with extrapulmonary manifestations(r=-0.334,P=0.038).Conclusion BALF composition in children experiencing acute MPP predominantly consists of neutrophils.Moreover,there exists a correlation wherein a decrease in the percentage of BALF lymphocytes corresponds with an elevated occurrence of extrapulmonary manifestations.
万方数据
维普
