Objective To construct a prediction model for the therapeutic effect of electronic bronchoscopy in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation based on multidimensional clinical indicators, and to validate the model's efficacy clinically. Methods A total of 168 pediatric patients with Mycoplasma pneumoniae pneumonia and pulmonary consolidation who underwent electronic bronchoscopy treatment at our hospital from January 2022 to December 2024 were selected as the study subjects. According to the treatment outcome, they were divided into an effective group (125 cases) and an ineffective group (43 cases). Univariate analysis was conducted on multimodal data from the two groups, including medical imaging, clinical laboratory indicators, symptoms, and signs. Binary logistic regression was used to analyze the risk factors affecting the efficacy of electronic bronchoscopy treatment in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation. The predictive performance of the identified risk factors and a nomogram for the treatment outcome was evaluated using the receiver operating characteristic (ROC) curve. Results Significant differences were observed between the ineffective and effective groups in the extent of pulmonary consolidation, presence of atelectasis, NLR, CRP, and serum mycoplasma antibody titers (P<0.05). Large consolidation area, presence of atelectasis, elevated NLR, elevated CRP, and antibody titers ≥1∶320 were risk factors for poor treatment outcomes (P<0.05). The AUC values for the extent of consolidation, atelectasis, NLR, CRP, antibody titers, and the combined prediction were 0.729, 0.637, 0.898, 0.754, 0.709, and 0.972, respectively. The combined prediction achieved the highest AUC, along with the highest sensitivity (95.3%) and specificity (90.4%). Conclusion A prediction model based on multidimensional clinical indicators—including imaging findings (extent of consolidation, atelectasis) and laboratory markers (NLR, CRP, serum antibody titers) —demonstrates strong efficacy in predicting the therapeutic outcomes of electronic bronchoscopy in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation, with good sensitivity and specificity.
Key words
multidimensional clinical indicators /
Mycoplasma pneumoniae pneumonia /
lung consolidation /
electronic bronchoscopy /
treatment effect
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References
[1] GAO L, SUN Y.Laboratory diagnosis and treatment of Mycoplasma pneumoniae infection in children: a review[J]. Ann Med, 2024, 56(1): 2386636.
[2] SHEN X, JIN Z, CHEN X, et al.Single-cell transcriptome atlas revealed bronchoalveolar immune features related to disease severity in pediatric Mycoplasma pneumoniae pneumonia[J]. MedComm, 2024, 5(10): e748.
[3] ROWLANDS RS, MEYER SAUTEUR PM, BEETON ML, et al.Mycoplasma pneumoniae: not a typical respiratory pathogen[J]. J Med Microbiol, 2024, 73(10): 001910.
[4] ZHUO LY, HAO JW, SONG ZJ, et al.Predicting the severity of mycoplasma pneumoniae pneumonia in pediatric and adult patients: a multicenter study[J]. Sci Rep, 2024, 14(1): 22978.
[5] 吕田, 赵德育. 儿童肺炎支原体肺炎影像学表现与预后关系研究进展[J]. 传染病信息, 2025, 38(5): 506-511.
[6] 黄铖铖, 万小梅, 吴李龙, 等. 学龄前儿童肺炎支原体感染致肺实变/肺不张的危险因素分析[J]. 皖南医学院学报, 2024, 43(6): 539-542.
[7] 中华医学会儿科学分会呼吸学组, 国家呼吸系统疾病临床医学研究中心, 中华儿科杂志编辑委员会. 儿童肺炎支原体肺炎诊断与治疗循证指南 (2023)[J]. 中华儿科杂志, 2024, 62(12): 1137-1144.
[8] 代尧, 黎佳慧, 徐秀红, 等. 基于肺炎支原体DNA和外周血炎症指标构建儿童肺炎支原体肺炎预后评估模型[J]. 检验医学, 2024, 39(6): 568-572.
[9] ZHANG X, SUN R, JIA W, et al.Clinical characteristics of lung consolidation with Mycoplasma pneumoniae pneumonia and risk factors for Mycoplasma pneumoniae necrotizing pneumonia in children[J]. Infect Dis Ther, 2024, 13(2): 329-343.
[10] LI S, ZHANG QL, GUO RJ, et al.Quantitative evaluation and significance of ultrasound in bronchoalveolar lavage for lung consolidation in children with severe mycoplasma pneumonia[J]. Transl Pediatr, 2021, 10(9): 2325-2334.
[11] 左蕾, 黄毅, 薛莲, 等. 肺部超声监测在儿童肺炎支原体肺炎临床诊疗中的应用价值[J]. 中华超声影像学杂志, 2025, 34(3): 203-209.
[12] 张雪梅, 陈佩灵, 钟丽萍. 血清IL-25, CXCR4水平与肺炎支原体肺炎伴肺不张患儿呼吸力学指标及预后的关系[J]. 医学综述, 2023, 29(24): 5853-5858.
[13] LI S, ZHOU J, HE J, et al.Clinical profiles of mycoplasma pneumoniae pneumonia in children with different pleural effusion patterns: a retrospective study[J]. BMC Infect Dis, 2024, 24(1): 919.
[14] 唐青, 赵龙, 张雯, 等. 外周血NLR, PLR和MPVLR水平对儿童难治性肺炎支原体肺炎的预测价值[J]. 国际呼吸杂志, 2024, 44(9): 1061-1066.
[15] HU M, SHEN X, LI M, et al.Efficacy of bronchoalveolar lavage in treating mycoplasma pneumonia and bacterial pneumonia with atelectasis in children[J]. Transl Pediatr, 2025, 14(3): 432-441.
[16] 李革, 余怡如, 陈放, 等. NLR, 25- (OH) D3, IL-6, PCT与重症肺炎支原体肺炎患儿免疫功能和预后不良的关系研究[J]. 现代生物医学进展, 2023, 23(3): 461-465.
[17] 佘吉佳, 陈传贵, 邸咪. WBC, CRP, SAA, PCT在儿童肺炎支原体肺炎中的临床运用价值[J]. 检验医学与临床, 2023, 20(1): 11-14.
[18] LIANG M, ZHANG H, LI Y, et al.A prediction model for bronchoalveolar lavage in children with Mycoplasma pneumoniae pneumonia and consolidation[J]. Sci Rep, 2026, 16(1): 3152.
[19] 罗虎, 何雪莲. LDH, CRP, 中性杆状核粒细胞百分比在儿科支原体肺炎与细菌性肺炎鉴别诊断中的价值[J]. 标记免疫分析与临床, 2024, 31(2): 197-202.
[20] 张立霞, 朱峰, 李传景, 等. 重症肺炎支原体肺炎患儿CRP, LDH等实验室指标的预警价值及支气管镜下特点[J]. 中华全科医学, 2024, 22(7): 1098-1101.
[21] 辉琪, 崔玥, 张雯婷, 等. 血常规相关参数在儿童支原体肺炎中的表达及临床价值[J]. 临床血液学杂志, 2023, 36(12): 860-864.
[22] 柴彦艳, 邓芳, 许愿愿, 等. 重症肺炎支原体肺炎患儿临床特征与实验室指标及预后的关系[J]. 中华医院感染学杂志, 2025, 35(20): 3124-3127.
[23] 刘玉雄, 蔡强, 申敏, 等. 肺炎支原体肺炎患儿28天预后的影响因素[J]. 中华医院感染学杂志, 2025, 35(16): 2481-2484.
[24] 郝晓飞, 王育民, 宋惠芳, 等. 重症肺炎支原体肺炎患儿血清IL-8, IL-2, CRP及PCT表达水平及意义[J]. 中南医学科学杂志, 2026, 54(1): 138-141.
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