造成全球兒童死亡最常見之病因至今仍是肺炎，而黴漿菌肺炎菌（Mycoplasma pneumoniae）感染是造成兒童肺炎之重要病源。 有研究指出，黴漿菌肺炎菌(Mycoplasma pneumoniae)會誘發周邊血液中之單核球巨噬細胞（mononuclear phagocytes）分泌腫瘤壞死因子-α【Tumor necrosis factor-α（TNF-α）】及第六介白素【Interleukin-6（IL-6）】。然而腫瘤壞死因子-α及第六介白素其血清濃度與黴漿菌肺炎嚴重度間之關係，尚待釐清。 因此，我們測量黴漿菌肺炎病童，在疾病急性期之腫瘤壞死因子-α及第六介白素血清中濃度，以瞭解腫瘤壞死因子-α或第六介白素是否可作為黴漿菌肺炎之預後因子。 自1999年6月至2000年1月，共收集49位病童(24位男童、25位女童)住院第一天之血清，年齡分佈1至11歲(平均年齡4歲)，之前均無使用抗生素。另有15位(8位男童、7位女童)健康對照組，平均年齡3.7歲。 以enzyme-linked immunosorbent assays（ELISA）的方法來測量腫瘤壞死因子-α及第六介白素血清濃度。 依據總發燒天數大於三天或小於三天，可將病童分成兩組;及依照胸部X光之表現有無大葉性肺炎或肋膜積水，又可將病童分成兩組。 本研究中發現，黴漿菌肺炎病童，若是總發燒天數大於三天者，有較高之第六介白素血清中濃度（41.98 ± 67.46 pg/mL），而總發燒天數小於三天者，有較低之第六介白素血清中濃度（10.01 ± 11.74 pg/mL; p < 0.05）；腫瘤壞死因子-α血清濃度在兩組中，並無顯著的不同。若是病童之胸部X光以大葉性肺炎或肋膜積水表現者，有較高之第六介白素血中清濃度（58.11 ± 92.19 pg/mL），若是病童之胸部X光僅以氣管周圍浸潤表現者，有較低之第六介白素血清中濃度（15.94 ± 20.81 pg/mL; p < 0.05）；腫瘤壞死因子-α血清濃度在兩組中，亦無顯著的不同。故本研究認為，第六介白素之血清濃度比腫瘤壞死因子-α之血清濃度，更可以反映出黴漿菌肺炎病童之疾病嚴重度。; A prospective study was performed to assess the relationship among C-reactive protein (CRP), interleukin—6 (IL-6), tumor necrosis factor-α (TNF-α) serum concentrations and the outcome of mycoplasma pneumonia in children. Serum samples were obtained from 49 children with mycoplasma pneumonia in the first day of admission. The mycoplasma pneumonia was diagnosed by chest film, anti-Mycoplasma pneumoniae antibody particle agglutination screening test and anti-Mycoplasma pneumoniae IgM antibody enzyme-linked immunosorbent assays (ELISA) confirming test. The serum concentrations of IL-6 and TNF-α were measured by ELISA and the serum concentrations of CRP were measured by immunonephelometry. IL-6 concentrations of mycoplasma pneumonia patients with fever > 3 days (41.98±67.46 pg/mL) are significantly higher than those in patients with fever ? 3 days (10.01±11.74 pg/mL) (P<0.05). CRP concentrations of mycoplasma pneumonia patients with fever > 3 days (4.86±3.43 mg/dL) are significantly higher than those in patients with fever ? 3 days (1.23±1.24 mg/dL) (P<0.05). The serum CRP levels are correlated to serum IL-6 levels (r=0.7, p<0.05), but not correlated to serum TNF-α levels (r=0.11, p=0.43). These results suggest that IL-6 serum concentrations, rather than TNF-α, may be a potential indicator of the severity of mycoplasma pneumonia.
