Related Experiment Video
Updated: Jan 10, 2026
Measurement of the Pressure-volume Curve in Mouse Lungs
Published on: January 27, 2015
Pulmonary lesion volume ratio and laboratory parameters as risk factors for plastic bronchitis in pediatric
Jiahui Wu1, Fangfang Cheng1, Xiaoxing Kong1
1Department of Infectious Diseases, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, 215025, China.
Insights
Refractory Mycoplasma pneumoniae pneumonia (RMPP) can lead to plastic bronchitis (PB). Key risk factors for PB in children include elevated neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), and alanine aminotransferase (ALT), along with increased pulmonary lesion volume and reduced activated partial thromboplastin time (APTT).
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Refractory Mycoplasma pneumoniae pneumonia (RMPP) is a severe respiratory illness in children.
- Plastic bronchitis (PB) is a known complication of RMPP, necessitating identification of predictive factors.
- Early detection of PB risk can improve patient outcomes and guide treatment strategies.
Purpose of the Study:
- To identify clinical risk factors associated with the development of plastic bronchitis (PB) in pediatric patients diagnosed with refractory Mycoplasma pneumoniae pneumonia (RMPP).
- To develop a predictive model for early risk stratification of PB in pediatric RMPP cases.
Main Methods:
- A cohort of 361 pediatric RMPP patients undergoing bronchoscopy was divided into PB and non-PB groups.
- Clinical characteristics, laboratory markers (including NLR, LDH, ALT, APTT), and chest CT findings were analyzed.
- Multivariate logistic regression and ROC analysis identified independent predictors and assessed diagnostic performance; a scoring system was developed.
Main Results:
- PB patients exhibited higher rates of extrapulmonary lesions, pleural effusion, and treatment resistance.
- Independent predictors for PB included elevated NLR (≥3.30), LDH (≥451.0 U/L), ALT (≥21.75 U/L), pulmonary lesion volume ratio (≥8.23%), and reduced APTT (≤35.95s).
- A combined predictive model achieved 85.70% sensitivity and 84.90% specificity (AUC=0.92), enabling effective risk stratification into high, middle, and low-risk groups.
Conclusions:
- Elevated NLR, LDH, ALT, increased pulmonary lesion volume, and reduced APTT are significant independent risk factors for PB in pediatric RMPP.
- A scoring system integrating these factors allows for early identification and risk stratification of PB.
- This facilitates timely clinical intervention for pediatric RMPP patients at risk of developing PB.
Background:
Refractory Mycoplasma pneumoniae pneumonia (RMPP) frequently leads to complications, including plastic bronchitis (PB). This study aimed to identify clinical risk factors for PB development in pediatric RMPP.
Methods:
A total of 361 pediatric patients with RMPP underwent bronchoscopy intervention were divided into a PB group and a non-PB group. Clinical characteristics, laboratory parameters, and chest CT findings were evaluated. Univariate analysis was initially performed to identify potential risk factors of PB, followed by multivariate logistic regression analysis to determine independent predictors, with receiver operating characteristic (ROC) analysis assessing their predictive value. A scoring system for PB risk assessment was developed based on odds ratio (OR) values.
Results:
PB patients showed significantly higher rates of extrapulmonary lesions (48.98% vs. 18.59%, p < 0.001), pleural effusion (59.18% vs. 25.64%, p < 0.001), and treatment resistance. Furthermore, PB patients demonstrated significantly elevated levels of neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), D-dimer (DD), and pulmonary lesion volume ratio. Conversely, platelet count (PLT), prealbumin (PA), albumin (ALB), complement 3 (C3), complement 4 (C4), activated partial thromboplastin time (APTT), and the proportion of neutrophils in bronchial alveolar lavage fluid (BALF) were significantly lower compared to non-PB group (all P-values < 0.05). Multivariate analysis identified five independent predictors: NLR ≥ 3.30 (OR 2.92), LDH ≥ 451.0 U/L (OR 4.91), ALT ≥ 21.75 U/L (OR 5.68), pulmonary lesion volume ratio ≥ 8.23% (OR 8.83), and APTT ≤ 35.95s (OR 4.20). The combination of these predictors demonstrated strong diagnostic performance, with a sensitivity of 85.70%, specificity of 84.90%, and an area under the curve (AUC) of 0.92 for identifying PB cases. Using a scoring system based on ORs, we stratified 361 RMPP patients into risk groups: the high-risk group had 32 (60.38%) PB out of 53, the middle-risk group had 13 (22.02%) PB out of 59, and the low-risk group had 4 (1.61%) PB out of 249.
Conclusions:
Elevated NLR, increased LDH, higher ALT, greater pulmonary lesion volume ratio, and reduced APTT were identified as independent risk factors for PB. Pulmonary lesion volume ratio combined with key laboratory markers may facilitate early risk stratification and clinical intervention for PB in pediatric RMPP.
More Related Videos
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:15Respiratory Volumes
Tidal Volume (TV) Tidal volume (TV) is the air inhaled or exhaled in a...
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...