儿童重症肺炎支原体肺炎继发感染后闭塞性细支气管炎的危险因素研究

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中图分类号：R725.6 文献标志码：A DOI：10.3969/j.issn.1003-1383.2026.02.006

A study on risk factors for post-infectious bronchiolitis obliterans secondary to severe Mycoplasma pneumonia pneumonia in children

ZENG Li'e ⋅a ， LIN Jieru ⋅a ， CHEN Qionghua ， HONG Yizhu ⋅b ， ZHENG Jingyang aδ （a.RespiratoryDepartment，b. RehabilitationDepartment，Quanzhou Maternal and Child Health Hospital ⋅⋅ Children’s Hospital，Quanzhou 3620oo，Fujian，China）

【Abstract】ObjectiveTo investigateindependentrisk factors forpost-infectiousbronchiolitisobliterans（PIBO）inchildren with severe Mycoplasma pneumoniae pneumonia（SMPP），soas to provide evidencefor earlyidentificationof high-risk patients.MethodsAtotal of 230 children with SMPPwho were diagnosedandtreatedat Quanzhou Maternal and Child Health Hospital ⋅ Children's Hospital from January 2O18 to January 2O24 were enrolled.They were divided into case group （ n=54 ）and control group（ n=176 ）based on the occurrence of PIBO.And then，general characteristics，biological，and clinical features werecomparedbetween the PIBOcasegroupandcontrolgroup，and variables identifiedinunivariateanalysis（ P<0.1 ）wereincluded inamultivariatelogisticregressionmodel toidentify independentrisk factors.ResultsUnivariateanalysisrevealedthatmultipleclinicalseverity-relatedvariables，aswellasinflammationandcoagulationrelatedidicators，were associated with PIBO（ P<0.05 ）.In multivariate analysis，the duration from symptom onset to admission （ OR= 1.084，95% CI：1.035-1.135， P=0.001 ）and D-dimer （ OR=1.446 ，95% CI ：1.087 -1.925， P=0.011 ）were independentrisk factors.ConclusionDelayed presentationand elevated D-dimerlevelsare independentrisk factors forsecondaryPBOafter SMPP，which provides biologicallyplausiblerationaleforearlyclinical identificationand intervention.

【Keywords】children；severe Mycoplasma pneumoniaepneumonia （SMPP）；post-infectious bronchiolis obliterans （PI-BO）；risk factors

肺炎支原体（Mycoplasma pneumoniae，MP）是引起学龄前期和学龄期儿童社区获得性肺炎的常见病原体之一[1]，其耐药性问题已构成重大公共卫生挑战。（剩余9099字）