Clinical characteristics and related inflammatory factors of refractory Mycoplasma pneumoniae pneumonia in children
10.3760/cma.j.issn.1673-4912.2025.04.007
- VernacularTitle:儿童难治性肺炎支原体肺炎的临床特征和炎症性因子研究
- Author:
Liping ZHANG
1
;
Jinju WANG
;
Guiliang HAO
Author Information
1. 青岛大学附属妇女儿童医院呼吸科 266000
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae;
Refractory Mycoplasma pneumoniae pneumonia;
Children;
Bronchoalveolar lavage fluid;
Cytokine
- From:
Chinese Pediatric Emergency Medicine
2025;32(4):273-278
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical features and inflammatory factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children,and to explore the early prediction methods of RMPP.Methods:Children with Mycoplasma pneumoniae who were hospitalized in the Respiratory Department of Qingdao Women and Children's Hospital from January 2022 to December 2023 and underwent electronic bronchoscopic lavage were selected as the study objects.They were divided into RMPP group and GMPP group according to the severity of illness.Clinical features and inflammatory factors between the two groups were compared,and the risk factors of RMPP were analyzed by multivariate Logistic regression model.Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive values.Results:A total of 232 children were included,including 114 cases in RMPP group and 118 cases in GMPP group.Compared with GMPP group,children in RMPP group were younger,had longer fever time and hospitalization time,and had higher levels of blood C-reactive protein,D-dimer,and lactate dehydrogenase(LDH),as well as higher proportion of pleural effusion observed in imaging.The cytokine levels of interferon(IFN)-α,IFN-γ,interleukin(IL)-2,IL-5,IL-6,IL-1β,IL-10 and IL-17 in bronchoalveolar lavage fluid (BALF) were higher in RMPP group.The differences were statistically significant (all P<0.05).Multivariate Logistic analysis showed that longer hospitalization time and fever time，increased levels of D-dimer and LDH in plasma,increased IL-5,IL-6,IL-17,IL-1β and IFN-α in BALF were independent risk factors for RMPP (all P<0.05).The area under ROC curve of hospitalization time,fever time,D-dimer,LDH,IL-5,IL-6,IL-17 and IL-1β were 0.669,0.857,0.606,0.811,0.686,0.890,0.647 and 0.691，respectively(all P<0.05).Among these,the diagnostic value of fever time,LDH and IL-6 was higher.The optimum critical value of fever time was 6.5 days,with a sensitivity of 97.40% and a specificity of 64.90%.The optimum critical value of LDH was 420.77U/L,with a sensitivity of 64.90% and a specificity of 89.50%.The optimal critical value of IL-6 was 293.04pg/mL,with a sensitivity of 91.2% and a specificity of 82.5%. Conclusion:Children with RMPP have long fever time and high inflammatory index.When children with Mycoplasma pneumoniae pneumonia have fever time >6.5 days,blood LDH>420.77 U/L and IL-6>293.04 pg/mL in BALF,it is helpful to identify RMPP at an early stage.
