Risk factors and prediction models for bronchitis obliterans after severe Mycoplasma pneumoniae pneumonia with plastic bronchitis in children

儿童重症肺炎支原体肺炎合并塑型性支气管炎后发生闭塞性支气管炎的危险因素及预测模型

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Abstract

OBJECTIVE: To investigate the relevant risk factors for bronchitis obliterans and develop a predictive nomogram for bronchitis obliterans in children with severe Mycoplasma pneumoniae pneumonia(SMPP). METHODOLOGY: This was a retrospective study. This study analyzed the clinical data of Xingtai People's Hospital, Xingtai Emergency Center children with SMPP from September 2021 to September 2025, and categorized them into the bronchitis obliterans and PB groups. SPSS 26.0 statistical software was used for data organization and analysis. RESULTS: Four hundred and sixty-four children with SMPP were finally included, of which 27(5.8%) children with PB were complicated by bronchitis obliterans. According to the chi square test and Mann Whitney U test, it was found that the gender, age, duration of fever, duration of cough, white blood cells, neutrophils, eosinophils CRP, alanine aminotransferase IL-6, IL-10, the comparison of tumor necrosis factor, APTT, D-dimer, aspartate aminotransferase, immunoglobulin E, and immunoglobulin G showed no statistically significant differences(P>0.05). The lactate dehydrogenase levels in patients with bronchitis obliterans were higher than those in patients with PB(P<0.05). The immunoglobulin A levels in patients with bronchitis obliterans were lower than those in patients with(P<0.05). The results showed that a higher level of LDH was an independent risk factor for bronchitis obliterans, while a higher level of immunoglobulin A was an independent protective factor for bronchitis obliterans. CONCLUSION: The increase of lactate dehydrogenase is an independent risk factor for bronchitis obliterans. The lactate dehydrogenase and immunoglobulin A have good sensitivity and specificity for building a nomogram prediction model for the risk of bronchitis obliterans.

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