Analysis of risk factors for multiple bronchoalveolar lavage in children with mycoplasma pneumoniae pneumonia
Objective To investigate the risk factors of multiple bronchoalveolar lavage(BAL)in children with mycoplasma pneumoniae pneumonia(MPP).Methods A retrospective analysis was conducted on clinical data of 176 children diagnosed with MPP and treated with BAL at the Department of Pediatrics,Weifang People's Hospital from March 2021 to March 2023.According to the times of BAL,the children were divided into single group and multiple group(≥2 times).Both univariate and multivariate logistic regression analyses were used to analyze the relevant influencing factors of the two groups,receiver operating characteristic(ROC)curve was used to analyze that the relevant factors to evaluate the predictive value of multiple BAL in MPP children.Results Among the 176 children,129 were in the single group and 47 were in the multiple group.The multiple group exhibited significantly higher pre-BAL fever duration,pleural effusion ratio,neutrophil percentage,platelet count(PLT),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),D-dimer(DD),alanine aminotransferase(ALT),lactate dehydrogenase(LDH),mycoplasma pneumoniae antibodies(MP)-IgG,MP-IgM,and the proportions of plastic sputum plugs or obstruction compared to the single group(t/Z/x2=-9.140-66.458,P＜0.05).The results of multivariate logistic regression analysis showed that DD(OR=2.395,95％CI:1.262-4.544),pre-BAL fever duration(OR=1.675,95％CI:1.048-2.678),neutrophil percentage(OR=1.120,95％CI:1.001-1.254),ALT(OR=1.056,95％CI:1.006-1.108),and presence of plastic sputum plugs or obstruction(OR=279.875,95％CI:10.925-7 170.118)as independent risk factors for multiple BAL in children with MPP(P＜0.05).The ROC curve analysis indicated that DD had an area under the curve(AUC)of 0.951(95％CI:0.920-0.982,P＜0.001)with the optimal cutoff value of 2.085 μg/mL.Pre-BAL fever duration had an AUC of 0.862(95％CI:0.803-0.921,P＜0.001)with the optimal cutoff value of 7.5 days.Neutrophil percentage had an AUC of 0.806(95％CI:0.735-0.876,P＜0.001)with the optimal cutoff value of 69.25％.ALT had an AUC of 0.774(95％CI:0.691-0.850,P＜0.001)with the optimal cutoff value of 20.5 U/L.Conclusion Excessive immune inflammatory response,significant elevation of ALT and the development of plastic bronchitis are risk factors for multiple BAL in children with MPP.
万方数据
维普
