Logistic regression analysis of influencing factors of bronchial lesions in children with Mycoplasma pneumonia

Logistic regression analysis of influencing factors of bronchial lesions in children with Mycoplasma pneumonia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Logistic regression analysis of influencing factors of bronchial lesions in children with Mycoplasma pneumonia Xvli Kang, Ziqi Liu, Yingying Li This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8771843/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Objective: To investigate the incidence, clinical features, laboratory indices and independent risk factors of bronchial organic lesions in children with Mycoplasma pneumoniae pneumonia (MPP) after standard treatment. Methods: According to bronchoscopy results,383 cases of MPP were divided into organic lesion group and non-organic lesion group. The clinical characteristics and laboratory indexes of the two groups were compared. The independent risk factors of organic lesions were analyzed by Logistic regression. Results: The incidence of bronchial organic lesions in children with MPP was 17.5%. Compared with the non-organic lesion group, the proportion of moist rales in the organic lesion group was significantly lower (59.70% vs 77.53%, P<0.05), and the duration of normal body temperature was significantly prolonged (5.85±2.52 days vs 5.06±2.60 days, P<0.05). In laboratory indicators, the levels of D-dimer (DD) and fibrinogen degradation product (FDP) were significantly elevated, while the levels of albumin and creatine kinase (CK) were significantly reduced in the organic lesion group (all P<0.05). At follow-up, the white blood cell count (WBC) in the organic lesion group was significantly higher than that in the non-organic lesion group (P<0.05). Logistic regression analysis showed that negative moist rales (OR=0.302,95% CI: 0.159-0.575) and neutrophil count (NC) at follow-up (OR=1.053,95% CI: 1.005-1.104) were independent risk factors for bronchial organic lesions in children with MPP (all P<0.05). Conclusion: The incidence of bronchial organic lesions in children with MPP is about 17.5%. The negative sputum crackles and elevated NC in follow-up visits are independent risk factors. Clinicians should pay attention to such children and perform bronchoscopy as early as possible to improve prognosis. Mycoplasma pneumoniae pneumonia children bronchial organic lesions moist rales neutrophil risk factors Figures Figure 1 Introduction Mycoplasma pneumoniae pneumonia (MPP) is one of the major pathogens of community-acquired pneumonia (CAP) in children, particularly prevalent among school-aged and preschool children, accounting for 10%-40% of pediatric CAP cases [ 1 ]. The pathogenesis of MPP is primarily associated with direct damage to the airway mucosa by Mycoplasma pneumoniae (MP) and the induction of host immune inflammatory responses, leading to airway epithelial cell necrosis, ciliary dysfunction, and airway hyperresponsiveness [ 2 ]. In recent years, with the increasing prevalence of MP drug resistance and the rise in severe MPP cases, some children may develop organic airway lesions during the course of the disease, such as moldy secretions (mucous plugs), necrotic and desquamated bronchial mucosa, bronchial stenosis, or obstruction [ 3 ]. These lesions can result in airflow limitation, prolonged inflammation, and treatment resistance, and in severe cases, may progress to bronchiolitis obliterans (BO), causing irreversible long-term pulmonary function impairment in children [ 4 ]. Although the hazards of MPP-associated airway organic lesions have garnered clinical attention, their early identification remains challenging. Current studies indicate that the incidence of MPP combined with airway organic injury ranges from 15.2% to 20.8% [13]. However, due to the lack of specific clinical manifestations in the early stages of such lesions, some children fail to undergo timely bronchoscopy for definitive diagnosis, missing the optimal window for clearing mucus plugs and relieving airway obstruction, leading to disease progression or exacerbation [ 5 ]. Previous research has predominantly focused on the etiological characteristics, drug resistance, and critical risk factors of MPP [ 6 – 7 ], while systematic studies on the clinical features, laboratory marker associations, and independent risk factors of airway organic lesions remain scarce. Particularly, there is a lack of dynamic correlation data between follow-up period markers (e.g., neutrophil counts) and disease progression. Therefore, clarifying the clinical and laboratory characteristics of airway organic lesions in MPP patients and screening reliable early identification indicators are of great significance for guiding timely bronchoscopic intervention and improving patient prognosis. In this study, MPP patients were divided into bronchial organic lesion group and non-organic lesion group through bronchoscopy, and the differences in clinical characteristics and laboratory indicators between the two groups were compared and analyzed. The independent risk factors of organic lesions were also explored, aiming to provide a basis for the early identification of airway organic lesions in MPP. Experimental Methodology This study employed a retrospective research method, with the study site being the Department of Pediatrics at Shunyi District Hospital in Beijing. A total of 383 children meeting the diagnostic criteria for MPP were selected, who underwent bronchoscopy treatment during hospitalization. The selected time range was from March 2021 to December 2024, with ages ranging from 1 to 16 years.All the children involved in the study obtained the informed consent from their parents, and this research has been approved by the Ethics Committee of Shunyi District Hospital in Beijing (Approval Number: 2026-L-005). This study enrolled 383 children with MPP (Mycoplasma pneumoniae pneumonia), ranging in age from 1 to 16 years. All patients met the diagnostic and therapeutic criteria outlined in the Expert Consensus on Diagnosis and Treatment of Mycoplasma Pneumonia in Children (2015 edition). The primary clinical manifestations included fever, cough, and dyspnea, with some patients exhibiting systemic symptoms such as dry and wet rales, and pulmonary imaging revealed lung consolidation and corresponding changes. Additionally, any of the following conditions was required: serum MP-IgM antibody levels > 1.1 or positive nasopharyngeal swab test results. The disease course was documented, including changes in signs such as body temperature, cough, wheezing, and wet rales, along with their duration. The presence of allergic diseases or relevant family history was also recorded. Exclusion criteria included patients with chronic lung disease, recurrent respiratory infections, a history of recurrent wheezing or asthma, bronchopulmonary dysplasia, immunosuppressive or immunodeficiency disorders, severe cardiac, hepatic, or renal diseases, malignancies, or incomplete case information. Initial laboratory tests are completed within 24 hours after the child's admission, including white blood cell count (WBC), neutrophil count (NC), lymphocyte count (LC), monocyte count (MC), eosinophil count (EC), platelet count (PLT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer (DD), fibrin degradation products (FDP), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (Alb), creatine kinase (CK), and creatine kinase isoenzyme (CK isoenzyme). CK-MB), and complete pulmonary CT examination; recheck WBC, NC, LC, MC, EC, PLT, and CRP after standard treatment protocol. All pediatric patients underwent complete fiberoptic bronchoscopy with a 4–6 hour preoperative fasting period. Thirty minutes prior to the procedure, intramuscular injections of atropine (0.01–0.02 mg/kg) and midazolam (0.1–0.3 mg/kg, maximum dose 4 mg per dose) were administered. A 2% lidocaine solution was administered via nasal and oral routes in three to four doses. The bronchoscope model was selected based on the patient's age. The bronchoscope was inserted through the nasal cavity and epiglottis into the trachea and left/right bronchial openings, with the tip reaching the lesion site and embedding into the bronchial lumen. Bronchoalveolar lavage (BAL) was performed using 0.9% normal saline at 37°C. For areas where mucus plugs were difficult to clear during local lavage, they were removed using a brush or biopsy forceps and slowly withdrawn from the fiberoptic bronchoscope. The patients were divided into organic lesion group and non-organic lesion group according to bronchoscopic findings. Non-organic lesion group included mucosal congestion, nodular hyperplasia and increased secretions, while organic lesion group included plastic secretions, bronchial mucosal necrosis and airway stenosis. statistical analysis Statistical analysis was performed using SPSS25.0 software. Measurement data conforming to normal distribution were expressed as mean ± standard deviation (x ± s). Comparisons between two groups were conducted using the independent samples t-test. Non-normally distributed data were presented as medians, and comparisons between groups were performed using the Wilcoxon rank sum test. The statistical significance threshold was set at P < 0.05. Categorical data were expressed as percentages (%), and intergroup comparisons were analyzed using the χ2 test. For the risk factors of tracheal mucus plug formation in children with bronchiolitis, we performed logistic regression analysis (variable selection criteria: P < 0.2; exclusion criteria: P ≥ 0.2; two-tailed significance level α = 0.05). RESULTS clinical features A total of 383 children with MPP underwent bronchoscopy, among which 316 cases had non-organic lesions and 67 cases (17.5%) had organic lesions. The age of children with non-organic lesions was 7.85 ± 2.56 years, while that of children with organic lesions was 8.00 (6.00,10.00) years, with no statistically significant difference between the two groups. The gender distribution was as follows: 160 males and 156 females in the non-organic lesion group, and 26 males and 41 females in the organic lesion group, respectively, with no statistically significant difference (P > 0.05). The presence of moist rales accounted for 77.53% in children with non-organic lesions and 59.70% in those with organic lesions, with a statistically significant difference (P < 0.05). The duration of normal body temperature was 5.06 ± 2.60 days in children with non-organic lesions and 5.85 ± 2.52 days in those with organic lesions, with a statistically significant difference (P < 0.05). There were no statistically significant differences between the two groups in terms of cough, wheezing, stridor, history of allergic diseases, family history of allergies, duration of cough, or duration of moist rales resolution (P > 0.05). See Table 1 . Table 1 Comparison of clinical characteristics between children with bronchial non-organic lesions and organic lesions in MPP non-organic lesion group organic lesion group T/χ P Gender (Male/Female) 160/156 26/41 3.095 0.079 Age (years) 7.85 ± 2.56 8.00(6.00, 10.00) −0.274 0.784 Fever 92.72 100 5.188 0.023 Temperature (℃) 38.76 ± 3.59 39.17 ± 0.69 −0.921 0.357 Cough 99.46 100 0.217 0.641 Pant 0.32 1.49 1.472 0.225 Bubble 77.53 59.70 9.230 0.002 Stridor 4.11 0 2.853 0.091 Allergies diseases 16.14 23.88 2.295 0.130 Allergy family 0.32 0 0.213 0.645 Duration of fever(days) 5.06 ± 2.60 5.85 ± 2.52 −2.269 0.024 Duration of cough (days) 18.80 ± 8.17 20.39 ± 9.42 −1.405 0.161 Duration of wheezing (days) 4.72 ± 3.56 3.79 ± 3.79 1.915 0.056 laboratory result The DDI (Disease-Driven Index) in children with non-organic lesions (MPP) was 0.58 ± 0.39, while that in children with organic lesions was 1.02 ± 2.88, with a statistically significant difference (P < 0.05). In both groups, the FDP (Fractional Disease Progression) was 2.86 ± 0.74 in children with non-organic lesions and 4.09 ± 7.62 in children with organic lesions, with a statistically significant difference (P < 0.05). The albumin levels in both groups were 39 (37.1, 41.4) in the non-organic lesion group and 54.47 ± 235.13 in the organic lesion group, with a statistically significant difference (P < 0.05). The CK levels in both groups were 80.71 ± 72.89 in the non-organic lesion group and 56.01 ± 29.61 in the organic lesion group, with a statistically significant difference (P 0.05). See Table 2 . Table 2 Comparison of laboratory results between children with bronchial non-organic lesions and organic lesions in MPP non-organic lesion group organic lesion group T/χ P WBC 7.59 ± 2.29 7.55 ± 1.97 0.085 0.933 NC 5.21 ± 4.51 4.92 ± 1.79 0.424 0.671 LC 2.18 ± 2.17 1.84(1.48, 2.22) −1.251 0.211 MC 0.67 ± 1.07 0.62 ± 0.21 0.349 0.728 EC 0.11 ± 0.18 0.13 ± 0.18 −0.602 0.547 PLT 251.74 ± 69.95 247(203, 291) −0.162 0.871 CRP 17.53 ± 24.04 21.96 ± 16.80 −1.305 0.193 ASR 30.71 ± 15.22 30(23, 39) −1.033 0.302 DD 0.58 ± 0.39 1.02 ± 2.88 −2.395 0.017 FDP 2.86 ± 0.74 4.09 ± 7.62 −2.565 0.011 LDH 235.80 ± 48.35 235.70 ± 41.70 0.064 0.949 AST 25.51 ± 10.49 23.15 ± 6.49 1.558 0.120 ALT 16.48 ± 13.63 14.29 ± 6.95 1.425 0.155 Albumin 54.47 ± 235.13 39(37.1, 41.4) −2.353 0.019 CK 80.71 ± 72.89 56.01 ± 29.61 2.479 0.014 CKMB 14.93 ± 12.79 13.88 ± 8.97 0.599 0.550 Re-examine the laboratory results After standard treatment, follow-up laboratory tests showed that the WBC count in the non-organic lesion group was 8.28 ± 3.00, while that in the organic lesion group was 8.76 (6.94,10.90), with a statistically significant difference (P 0.05). See Table 3 . Table 3 Comparison of laboratory re-examination results between children with bronchial non-organic lesions and organic lesions in MPP non-organic lesion group organic lesion group T/χ P WBC 8.28 ± 3.00 8.76(6.94, 10.90) −2.257 0.024 NC 5.10 ± 5.10 6.38 ± 7.30 −1.928 0.055 LC 2.78 ± 1.41 2.78 ± 1.41 −1.701 0.090 MC 0.52 ± 0.25 0.51(0.33, 0.64) −0.264 0.792 EC 0.10 ± 0.14 0.09 ± 0.11 −0.699 0.485 PLT 342.01 ± 103.76 346(270, 424) −0.953 0.341 CRP 9.50 ± 17.99 8.65 ± 12.12 0.479 0.633 binary logistic regression Regression analysis was performed with the following covariates selected for P < 0.2: gender, moist rales, wheezing, history of allergic diseases, duration of normal body temperature, duration of cough, duration of moist rales, DD, FDP, AST, ALT, albumin, CK, CK-MB, and follow-up WBC, NC, LC. The goodness-of-fit test yielded P = 0.61, indicating a good fit. The results revealed that the presence of moist rales (OR 0.302; 95% confidence interval, 0.159–0.575), ALT level (OR 0.970; 95% confidence interval, 0.882–1.067), CK level (OR 0.989; 95% confidence interval, 0.980–0.998), and follow-up NC level (OR 1.053; 95% confidence interval, 1.005–1.104) were independent risk factors for bronchial organic lesions caused by MPP (P < 0.05), as shown in Table 4 . Figure 1 . Table 4 Logistic regression analysis of risk factors associated with the formation of bronchial organic lesions in MPP variable regression coefficient (β) SE χ 2 P OR(95% CI) Gender 0.359 0.302 1.412 0.235 1.433(0.792–2.592) Bubble −1.198 0.329 13.270 0.000 0.302(0.159–0.575) Allergic diseases 0.607 0.367 2.731 0.098 1.834(0.893–3.766) Duration of fever 0.123 0.063 3.791 0.052 1.313(0.999–1.279) Duration of coughing 0.019 0.018 1.18 0.276 1.019(0.985–1.055) WBC 0.015 0.073 0.045 0.833 1.016(0.880–1.172) NC 0.052 0.024 4.475 0.029 1.053(1.005–1.104) LC 0.085 0.094 0.825 0.364 1.089(0.906–1.309) DD −0.556 0.601 0.855 0.355 0.574(0.177–1.863) FDP 0.518 0.333 2.413 0.120 1.678(0.873–3.225) AST 0.002 0.029 0.007 0.933 1.002(0.649–1.062) ALT −0.059 0.027 4.806 0.028 0.943(0.895–0.994) Albumin −0.030 0.049 0.385 0.535 0.970(0.882–1.067) CK −0.011 0.005 5.980 0.014 0.989(0.980–0.998) Discussion This study classified 383 children with MPP into an organic lesion group (17.5%) and a non-organic lesion group through bronchoscopy, investigating the clinical characteristics, laboratory index differences, and independent risk factors of organic lesions between the two groups. The results showed that the incidence of organic lesions (such as moldy secretions, airway stenosis, etc.) in MPP children was 17.5%, which is consistent with the reported incidence of organic airway lesions in MPP (15.2%-20.8%) in previous studies [ 8 ]. This suggests that organic airway lesions are not uncommon in MPP children, and early identification and intervention should be emphasized in clinical practice. Clinical characteristics of organic lesions in children with MPP This study found that the proportion of wet rales in children with organic lesions was significantly lower than that in the non-organic lesion group (59.70% vs 77.53%, P < 0.05), and the duration of normal body temperature was significantly longer than that in the non-organic lesion group (5.85 ± 2.52 days vs 5.06 ± 2.60 days, P < 0.05). Wet rales are signs produced by the vibration of exudate in the airway during pulmonary infection, while organic lesions (such as mucus plug obstruction, bronchial mucosal necrosis and sloughing) may lead to airway stenosis or occlusion, obstructing airflow and consequently reducing the auscultation of wet rales [ 9 ]. These results suggest that for children with MPP who exhibit inconspicuous wet rales, the possibility of organic airway obstruction should be considered to avoid delaying bronchoscopy due to negative auscultation findings. Cough and wheezing are core symptoms of MPP, caused by airway inflammation and spasm induced by mycoplasma infection. Regardless of the presence of organic lesions (such as mucus plugs or stenosis), children may exhibit airway hyperresponsiveness, leading to widespread symptoms with low specificity [ 10 ]. The low incidence of wheezing (0% in the organic lesion group vs 4.11% in the non-organic lesion group) may be related to the small sample size or the fact that organic lesions are primarily characterized by mucus plugs and mucosal necrosis, with airway stenosis not reaching the threshold for wheezing generation. The prolonged duration of normal body temperature may be associated with persistent inflammation caused by organic lesions. Organic airway injuries (e.g., mucus plugs) can serve as an inflammatory "reservoir," impeding drug penetration and the clearance of inflammatory factors, thereby leading to prolonged systemic inflammatory responses [ 11 ]. In this study, the duration of normal body temperature in the organic lesion group was 0.79 days longer than that in the non-organic lesion group. Although the absolute difference was not significant, the statistical significance was marked, suggesting that organic lesions may be one of the underlying reasons for the difficulty in controlling inflammation in children with MPP. Allergic factors may exacerbate MPP symptoms through airway hyperresponsiveness, whereas organic lesions are primarily associated with direct mycoplasma-induced damage, mucus plug formation, and airway remodeling, with allergic immune mechanisms playing a relatively minor role. The proportion of children with a history of allergic diseases in the samples was low (16.14% in the non-organic group and 23.88% in the organic group), which may not have reached the statistical significance threshold [ 12 ]. Cough duration is influenced by multiple factors such as infection control and airway repair. After bronchoscopic interventions (e.g., lavage, mucus plug clearance) in both groups, airway patency improved, and the duration of cough and moist rales may have been homogenized by the intervention measures. The difference in the time to disappearance of moist rales approached the critical value (P = 0.056), which may be related to insufficient sample size. Correlation between laboratory indices and organic lesions of the MPP airway Laboratory results demonstrated that all MPP patients, regardless of the presence of organic lesions, exhibited systemic inflammatory responses induced by Mycoplasma infection. Conventional inflammatory markers such as WBC, NC, and CRP were generally elevated during the acute phase, but they lacked specificity for localized organic changes in the airways (e.g., mucus plugs, mucosal necrosis). CRP levels were moderately elevated in both groups (non-organic group: 17.53 ± 24.04 mg/L; organic group: 21.96 ± 16.80 mg/L), which may be related to the insignificant difference in the degree of inflammation. The levels of DD (1.02 ± 2.88 vs 0.58 ± 0.39) and FDP (4.09 ± 7.62 vs 2.86 ± 0.74) were significantly elevated in the organic lesion group, while albumin (39.37,37.1, 41.4) and CK (56.01 ± 29.61 vs 80.71 ± 72.89) were significantly reduced (all P < 0.05). DD and FDP are sensitive indicators reflecting coagulation system activation. Airway inflammation in MPP patients can activate neutrophils and endothelial cells, releasing inflammatory factors (e.g., TNF-α, IL-6), damaging vascular endothelium, initiating coagulation cascade reactions, and leading to microthrombus formation [13]. Microthrombi can exacerbate airway microcirculatory disturbances, promote mucus plug formation and mucosal necrosis, and subsequently progress to organic lesions. The findings of this study are consistent with those of Li et al. [ 14 ], who reported significantly higher levels of D-dimethylpropanediol (DD) in children with mucous plug in the airway (MPP) compared to those without mucous plug. This suggests that coagulation dysfunction may be a key mechanism underlying the organic damage in MPP. Both groups of pediatric patients exhibited varying degrees of coagulation activation (e.g., elevated DD and FDP), with platelet (PLT) differences being masked by overall coagulation status. No significant differences were observed in liver function parameters (LDH, AST, ALT) or myocardial enzyme levels, suggesting that the organic lesions primarily affected the airway locally with minimal systemic impact, or that the proportion of pediatric patients with abnormal liver/kidney function in the samples was low [ 15 ]. No difference in CKMB levels indicated that myocardial injury was not significant in either group. The decrease in albumin levels may be associated with inflammatory consumption and impaired hepatic synthesis function. In severe infections, inflammatory factors inhibit hepatic albumin synthesis while enhancing catabolism, leading to hypoalbuminemia [ 16 ]. Conversely, hypoalbuminemia can exacerbate airway mucosal edema and promote the progression of organic lesions. Creatine kinase (CK), primarily localized in skeletal and cardiac muscles, exhibits unclear mechanisms of reduction. This phenomenon may be linked to muscle atrophy or metabolic disturbances caused by prolonged bed rest, requiring further research for confirmation. Independent risk factors for MPP airway organic lesions Logistic regression analysis revealed that moist rales (OR = 0.302,95% CI: 0.159–0.575), ALT (OR = 0.970,95% CI: 0.882–1.067), CK (OR = 0.989,95% CI: 0.980–0.998), and follow-up NC (OR = 1.053,95% CI: 1.005–1.104) were independent risk factors for MPP airway organic lesions (all P < 0.05). Negative moist rales (OR < 1) suggest that it may be a "negative predictive sign" of organic lesions. As previously mentioned, airway obstruction (e.g., mucus plugs) can reduce the conduction of moist rales. In clinical practice, if a child with MPP exhibits no obvious moist rales upon pulmonary auscultation but still presents with cough and dyspnea, organic lesions should be highly suspected [ 9 ]. The elevated neutrophil count (OR > 1) in follow-up visits indicates that persistent neutrophil-mediated inflammation is closely associated with organic lesions. During MPP-induced inflammation, neutrophils damage airway mucosa by releasing elastase and myeloperoxidase, leading to mucosal desquamation and granulation tissue hyperplasia, which subsequently results in airway stenosis [ 17 ]. The findings of this study support the role of neutrophils as key effector cells in MPP-induced airway injury, suggesting that controlling neutrophil infiltration may reduce the occurrence of organic lesions. The clinical significance of decreased ALT and CK remains unclear, potentially related to hepatic compensation or muscle metabolic inhibition, requiring further investigation with additional metabolic markers. In the univariate analysis, covariates with P-values < 0.2, including gender, history of allergic diseases, D-dimer (DD), and fibrinogen degradation products (FDP), were included in the regression model. However, these factors showed no statistical significance in the multivariate analysis. Potential reasons include: multicollinearity among variables; reduced statistical power due to insufficient sample size; and differences observed in some covariates in the univariate analysis being attributed to confounding effects [ 18 ]. Clinical Significance and Limitations This study is the first to reveal the association between moist rales, follow-up neutrophil count (NC), and other indicators with airway organic lesions in children with Mycoplasma pneumoniae pneumonia (MPP), providing a clinical basis for early identification of high-risk children. For MPP children with negative moist rales but elevated follow-up NC, early bronchoscopy is recommended to promptly remove mucus plugs and relieve airway obstruction, thereby improving prognosis. This study was designed as a single-center retrospective study, which has limitations such as limited sample size, absence of quantitative analysis of pathogen load and treatment regimens, and lack of long-term follow-up data. Therefore, it is not possible to evaluate the impact of organic lesions on the long-term pulmonary function of pediatric patients. Future multicenter prospective studies are needed to further explore the dynamic evolution patterns of organic lesions and develop targeted intervention strategies. Conclusion This study demonstrated that the incidence of airway organic lesions in children with Mycoplasma pneumoniae pneumonia (MPP) was 17.5%. Negative moist rales, prolonged duration of normal body temperature, elevated D-dimer (DD) and fibrinogen-dependent protein (FDP), as well as decreased albumin and creatine kinase (CK) levels, may indicate the risk of airway organic lesions. Logistic regression analysis confirmed that moist rales (OR = 0.302) and neutrophil count (NC) at follow-up visits (OR = 1.053) were independent risk factors. The clinical implications suggest that for MPP children with mild moist rales but elevated NC at follow-up, airway organic obstruction (e.g., mucus plugs or strictures) should be suspected, and early bronchoscopy is recommended to remove obstructions and improve inflammatory control. Concurrently, attention should be paid to changes in coagulation function (DD, FDP) and albumin/CK levels to aid in the early identification of high-risk children. Clinicians should prioritize MPP children with abnormal indicators and perform bronchoscopy as early as possible to improve prognosis. Abbreviations MPP mycoplasma pneumoniae pneumonia CAP community-acquired pneumonia MP Mycoplasma pneumoniae BO bronchiolitis obliterans WBC White blood cell count NC Neutrophil count LC Lymphocyte count MC Monocyte count EC Eosinophil count PLT Platelet CRP C-reactive protein ESR Erythrocyte sedimentation rate DD D-dimer FDP Fibrin degradation products LDH Lactate dehydrogenase ALT Alanine aminotransferase AST Aspartate aminotransferase CK Creatine kinase CK-MB Creatine kinase isoenzyme Declarations Ethics approval and consent to participate All the children involved in the study obtained the informed consent from their parents, and this research has been approved by the Ethics Committee of Shunyi District Hospital in Beijing (Approval Number: 2026-L-005).This research complies with the relevant requirements of the Helsinki Declaration. Consent for publication The data used in this study does not include personal details, pictures or videos.All the clinical data in this study have been anonymized. Therefore, this study does not apply for the publication of consent forms. Availability of Data and Materials All the data in this study were derived from the inpatient medical record system of the Shunyi District Hospital in Beijing. If you need to access this database, please contact Director Xvli Kang at the email address: [email protected] . In addition, the data used in this research has been compiled into a spreadsheet and has been uploaded in the relevant files. Funding The children in this study were selected from those undergoing routine diagnosis and treatment for mycoplasma pneumonia; the study utilized conventional clinical examination data; there were no additional costs and no funding support. 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Neutrophil histamine contributes to inflammation in mycoplasma pneumonia. J Exp Med. 2006 Dec 25;203(13):2907-17. Preisser JS, Das K, Benecha H, Stamm JW. Logistic regression for dichotomized counts. Stat Methods Med Res. 2016 Dec;25(6):3038-3056. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 09 Mar, 2026 Editor assigned by journal 04 Mar, 2026 Editor invited by journal 12 Feb, 2026 Submission checks completed at journal 11 Feb, 2026 First submitted to journal 11 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8771843","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":603260198,"identity":"22a5d0b7-c10f-4e7f-97ff-45d790422491","order_by":0,"name":"Xvli Kang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIie3QMQrCMBSA4SdCcHjSTZ5U7BUihVJB8Cp1cSri6Anq4gFavIRHSAl0avEALoKjHQIujkZcnEzcBPMvWd4XeA/A5frB6PXEOBdSCHW3J4RQVouy2H1BAGQdyh6zIMNtI6/9jEadrFYSEAJvID4TH1fLaZERdrE5yHUMk2KffCZjSCOuakJGmuQICT+ZiNdGPNEEg/YskVkQn9LwrDaEBDXYkWHeRp1cEw4V10cm8y50TMMb8tmcg7wodZ8Fnm8gOkbvXxjHn3WV1ZjL5XL9bw+LU0MhMOYM7QAAAABJRU5ErkJggg==","orcid":"","institution":"Shunyi District Hospital, Beijing","correspondingAuthor":true,"prefix":"","firstName":"Xvli","middleName":"","lastName":"Kang","suffix":""},{"id":603260200,"identity":"936dc72d-b0de-4f91-a524-421fd24be427","order_by":1,"name":"Ziqi Liu","email":"","orcid":"","institution":"Shunyi District Hospital, Beijing","correspondingAuthor":false,"prefix":"","firstName":"Ziqi","middleName":"","lastName":"Liu","suffix":""},{"id":603260204,"identity":"bf6e6662-2ed5-4d39-ba60-3fdaba89cb34","order_by":2,"name":"Yingying Li","email":"","orcid":"","institution":"Shunyi District Hospital, Beijing","correspondingAuthor":false,"prefix":"","firstName":"Yingying","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2026-02-03 06:38:41","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8771843/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8771843/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104557553,"identity":"dc31ea68-9067-4791-80fb-a7af7e04104a","added_by":"auto","created_at":"2026-03-13 09:28:00","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":51068,"visible":true,"origin":"","legend":"\u003cp\u003eForest plot of logistic regression analysis for risk factors associated with the formation of bronchial organic lesions in MPP\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8771843/v1/e6702a02c75532acc74804a3.png"},{"id":104557613,"identity":"41b25ad5-120c-4b20-bd1c-b24f868fee90","added_by":"auto","created_at":"2026-03-13 09:28:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":741212,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8771843/v1/0075b95b-141c-419e-86da-7cf3e5b2739a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Logistic regression analysis of influencing factors of bronchial lesions in children with Mycoplasma pneumonia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMycoplasma pneumoniae pneumonia (MPP) is one of the major pathogens of community-acquired pneumonia (CAP) in children, particularly prevalent among school-aged and preschool children, accounting for 10%-40% of pediatric CAP cases [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The pathogenesis of MPP is primarily associated with direct damage to the airway mucosa by Mycoplasma pneumoniae (MP) and the induction of host immune inflammatory responses, leading to airway epithelial cell necrosis, ciliary dysfunction, and airway hyperresponsiveness [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In recent years, with the increasing prevalence of MP drug resistance and the rise in severe MPP cases, some children may develop organic airway lesions during the course of the disease, such as moldy secretions (mucous plugs), necrotic and desquamated bronchial mucosa, bronchial stenosis, or obstruction [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These lesions can result in airflow limitation, prolonged inflammation, and treatment resistance, and in severe cases, may progress to bronchiolitis obliterans (BO), causing irreversible long-term pulmonary function impairment in children [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough the hazards of MPP-associated airway organic lesions have garnered clinical attention, their early identification remains challenging. Current studies indicate that the incidence of MPP combined with airway organic injury ranges from 15.2% to 20.8% [13]. However, due to the lack of specific clinical manifestations in the early stages of such lesions, some children fail to undergo timely bronchoscopy for definitive diagnosis, missing the optimal window for clearing mucus plugs and relieving airway obstruction, leading to disease progression or exacerbation [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Previous research has predominantly focused on the etiological characteristics, drug resistance, and critical risk factors of MPP [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], while systematic studies on the clinical features, laboratory marker associations, and independent risk factors of airway organic lesions remain scarce. Particularly, there is a lack of dynamic correlation data between follow-up period markers (e.g., neutrophil counts) and disease progression.\u003c/p\u003e \u003cp\u003eTherefore, clarifying the clinical and laboratory characteristics of airway organic lesions in MPP patients and screening reliable early identification indicators are of great significance for guiding timely bronchoscopic intervention and improving patient prognosis. In this study, MPP patients were divided into bronchial organic lesion group and non-organic lesion group through bronchoscopy, and the differences in clinical characteristics and laboratory indicators between the two groups were compared and analyzed. The independent risk factors of organic lesions were also explored, aiming to provide a basis for the early identification of airway organic lesions in MPP.\u003c/p\u003e"},{"header":"Experimental Methodology","content":"\u003cp\u003eThis study employed a retrospective research method, with the study site being the Department of Pediatrics at Shunyi District Hospital in Beijing. A total of 383 children meeting the diagnostic criteria for MPP were selected, who underwent bronchoscopy treatment during hospitalization. The selected time range was from March 2021 to December 2024, with ages ranging from 1 to 16 years.All the children involved in the study obtained the informed consent from their parents, and this research has been approved by the Ethics Committee of Shunyi District Hospital in Beijing (Approval Number: 2026-L-005).\u003c/p\u003e \u003cp\u003eThis study enrolled 383 children with MPP (Mycoplasma pneumoniae pneumonia), ranging in age from 1 to 16 years. All patients met the diagnostic and therapeutic criteria outlined in the Expert Consensus on Diagnosis and Treatment of Mycoplasma Pneumonia in Children (2015 edition). The primary clinical manifestations included fever, cough, and dyspnea, with some patients exhibiting systemic symptoms such as dry and wet rales, and pulmonary imaging revealed lung consolidation and corresponding changes. Additionally, any of the following conditions was required: serum MP-IgM antibody levels\u0026thinsp;\u0026gt;\u0026thinsp;1.1 or positive nasopharyngeal swab test results. The disease course was documented, including changes in signs such as body temperature, cough, wheezing, and wet rales, along with their duration. The presence of allergic diseases or relevant family history was also recorded. Exclusion criteria included patients with chronic lung disease, recurrent respiratory infections, a history of recurrent wheezing or asthma, bronchopulmonary dysplasia, immunosuppressive or immunodeficiency disorders, severe cardiac, hepatic, or renal diseases, malignancies, or incomplete case information.\u003c/p\u003e \u003cp\u003eInitial laboratory tests are completed within 24 hours after the child's admission, including white blood cell count (WBC), neutrophil count (NC), lymphocyte count (LC), monocyte count (MC), eosinophil count (EC), platelet count (PLT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer (DD), fibrin degradation products (FDP), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (Alb), creatine kinase (CK), and creatine kinase isoenzyme (CK isoenzyme). CK-MB), and complete pulmonary CT examination; recheck WBC, NC, LC, MC, EC, PLT, and CRP after standard treatment protocol.\u003c/p\u003e \u003cp\u003eAll pediatric patients underwent complete fiberoptic bronchoscopy with a 4\u0026ndash;6 hour preoperative fasting period. Thirty minutes prior to the procedure, intramuscular injections of atropine (0.01\u0026ndash;0.02 mg/kg) and midazolam (0.1\u0026ndash;0.3 mg/kg, maximum dose 4 mg per dose) were administered. A 2% lidocaine solution was administered via nasal and oral routes in three to four doses. The bronchoscope model was selected based on the patient's age. The bronchoscope was inserted through the nasal cavity and epiglottis into the trachea and left/right bronchial openings, with the tip reaching the lesion site and embedding into the bronchial lumen. Bronchoalveolar lavage (BAL) was performed using 0.9% normal saline at 37\u0026deg;C. For areas where mucus plugs were difficult to clear during local lavage, they were removed using a brush or biopsy forceps and slowly withdrawn from the fiberoptic bronchoscope.\u003c/p\u003e \u003cp\u003eThe patients were divided into organic lesion group and non-organic lesion group according to bronchoscopic findings. Non-organic lesion group included mucosal congestion, nodular hyperplasia and increased secretions, while organic lesion group included plastic secretions, bronchial mucosal necrosis and airway stenosis.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003estatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was performed using SPSS25.0 software. Measurement data conforming to normal distribution were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x\u0026thinsp;\u0026plusmn;\u0026thinsp;s). Comparisons between two groups were conducted using the independent samples t-test. Non-normally distributed data were presented as medians, and comparisons between groups were performed using the Wilcoxon rank sum test. The statistical significance threshold was set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Categorical data were expressed as percentages (%), and intergroup comparisons were analyzed using the χ2 test. For the risk factors of tracheal mucus plug formation in children with bronchiolitis, we performed logistic regression analysis (variable selection criteria: P\u0026thinsp;\u0026lt;\u0026thinsp;0.2; exclusion criteria: P\u0026thinsp;\u0026ge;\u0026thinsp;0.2; two-tailed significance level α\u0026thinsp;=\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eclinical features\u003c/p\u003e \u003cp\u003eA total of 383 children with MPP underwent bronchoscopy, among which 316 cases had non-organic lesions and 67 cases (17.5%) had organic lesions. The age of children with non-organic lesions was 7.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56 years, while that of children with organic lesions was 8.00 (6.00,10.00) years, with no statistically significant difference between the two groups. The gender distribution was as follows: 160 males and 156 females in the non-organic lesion group, and 26 males and 41 females in the organic lesion group, respectively, with no statistically significant difference (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The presence of moist rales accounted for 77.53% in children with non-organic lesions and 59.70% in those with organic lesions, with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The duration of normal body temperature was 5.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.60 days in children with non-organic lesions and 5.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52 days in those with organic lesions, with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There were no statistically significant differences between the two groups in terms of cough, wheezing, stridor, history of allergic diseases, family history of allergies, duration of cough, or duration of moist rales resolution (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of clinical characteristics between children with bronchial non-organic lesions and organic lesions in MPP\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003enon-organic lesion group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eorganic lesion group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT/χ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (Male/Female)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160/156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26/41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.00(6.00, 10.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.784\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTemperature (℃)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38.76\u0026thinsp;\u0026plusmn;\u0026thinsp;3.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.921\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.357\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e 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\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBubble\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStridor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.853\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.091\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAllergies diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.295\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAllergy family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.645\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of fever(days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;2.269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of cough (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.80\u0026thinsp;\u0026plusmn;\u0026thinsp;8.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.39\u0026thinsp;\u0026plusmn;\u0026thinsp;9.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.405\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.161\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of wheezing (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.79\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003elaboratory result\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe DDI (Disease-Driven Index) in children with non-organic lesions (MPP) was 0.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39, while that in children with organic lesions was 1.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88, with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In both groups, the FDP (Fractional Disease Progression) was 2.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74 in children with non-organic lesions and 4.09\u0026thinsp;\u0026plusmn;\u0026thinsp;7.62 in children with organic lesions, with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The albumin levels in both groups were 39 (37.1, 41.4) in the non-organic lesion group and 54.47\u0026thinsp;\u0026plusmn;\u0026thinsp;235.13 in the organic lesion group, with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The CK levels in both groups were 80.71\u0026thinsp;\u0026plusmn;\u0026thinsp;72.89 in the non-organic lesion group and 56.01\u0026thinsp;\u0026plusmn;\u0026thinsp;29.61 in the organic lesion group, with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No statistically significant differences were observed in WBC, NC, LC, MC, EC, PLT, CRP, ASR, LDH, AST, ALT, or CKMB between the two groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). See Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of laboratory results between children with bronchial non-organic lesions and organic lesions in MPP\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003enon-organic lesion group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eorganic lesion group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT/χ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e7.59\u0026thinsp;\u0026plusmn;\u0026thinsp;2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.55\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.933\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.21\u0026thinsp;\u0026plusmn;\u0026thinsp;4.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.92\u0026thinsp;\u0026plusmn;\u0026thinsp;1.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.424\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.671\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.84(1.48, 2.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.211\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.67\u0026thinsp;\u0026plusmn;\u0026thinsp;1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.728\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.602\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.547\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePLT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e251.74\u0026thinsp;\u0026plusmn;\u0026thinsp;69.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e247(203, 291)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.871\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e17.53\u0026thinsp;\u0026plusmn;\u0026thinsp;24.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.96\u0026thinsp;\u0026plusmn;\u0026thinsp;16.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.193\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eASR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e30.71\u0026thinsp;\u0026plusmn;\u0026thinsp;15.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30(23, 39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.302\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;2.395\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.09\u0026thinsp;\u0026plusmn;\u0026thinsp;7.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;2.565\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e235.80\u0026thinsp;\u0026plusmn;\u0026thinsp;48.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e235.70\u0026thinsp;\u0026plusmn;\u0026thinsp;41.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.949\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAST\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e25.51\u0026thinsp;\u0026plusmn;\u0026thinsp;10.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.15\u0026thinsp;\u0026plusmn;\u0026thinsp;6.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.558\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e16.48\u0026thinsp;\u0026plusmn;\u0026thinsp;13.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.29\u0026thinsp;\u0026plusmn;\u0026thinsp;6.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e54.47\u0026thinsp;\u0026plusmn;\u0026thinsp;235.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39(37.1, 41.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;2.353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e80.71\u0026thinsp;\u0026plusmn;\u0026thinsp;72.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.01\u0026thinsp;\u0026plusmn;\u0026thinsp;29.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.479\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCKMB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e14.93\u0026thinsp;\u0026plusmn;\u0026thinsp;12.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.88\u0026thinsp;\u0026plusmn;\u0026thinsp;8.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.599\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.550\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eRe-examine the laboratory results\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAfter standard treatment, follow-up laboratory tests showed that the WBC count in the non-organic lesion group was 8.28\u0026thinsp;\u0026plusmn;\u0026thinsp;3.00, while that in the organic lesion group was 8.76 (6.94,10.90), with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No statistically significant differences were observed in NC, LC, MC, EC, PLT, and CRP levels between the two groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of laboratory re-examination results between children with bronchial non-organic lesions and organic lesions in MPP\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003enon-organic lesion group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eorganic lesion group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT/χ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e8.28\u0026thinsp;\u0026plusmn;\u0026thinsp;3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.76(6.94, 10.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;2.257\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.10\u0026thinsp;\u0026plusmn;\u0026thinsp;5.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.38\u0026thinsp;\u0026plusmn;\u0026thinsp;7.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.928\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.78\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.78\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.090\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.51(0.33, 0.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.792\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.485\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePLT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e342.01\u0026thinsp;\u0026plusmn;\u0026thinsp;103.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e346(270, 424)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.953\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.341\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e9.50\u0026thinsp;\u0026plusmn;\u0026thinsp;17.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.65\u0026thinsp;\u0026plusmn;\u0026thinsp;12.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.479\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.633\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ebinary logistic regression\u003c/p\u003e \u003cp\u003eRegression analysis was performed with the following covariates selected for P\u0026thinsp;\u0026lt;\u0026thinsp;0.2: gender, moist rales, wheezing, history of allergic diseases, duration of normal body temperature, duration of cough, duration of moist rales, DD, FDP, AST, ALT, albumin, CK, CK-MB, and follow-up WBC, NC, LC. The goodness-of-fit test yielded P\u0026thinsp;=\u0026thinsp;0.61, indicating a good fit. The results revealed that the presence of moist rales (OR 0.302; 95% confidence interval, 0.159\u0026ndash;0.575), ALT level (OR 0.970; 95% confidence interval, 0.882\u0026ndash;1.067), CK level (OR 0.989; 95% confidence interval, 0.980\u0026ndash;0.998), and follow-up NC level (OR 1.053; 95% confidence interval, 1.005\u0026ndash;1.104) were independent risk factors for bronchial organic lesions caused by MPP (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic regression analysis of risk factors associated with the formation of bronchial organic lesions in MPP\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003evariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eregression coefficient (β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR(95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.433(0.792\u0026ndash;2.592)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBubble\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;1.198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.302(0.159\u0026ndash;0.575)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAllergic diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.607\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.367\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.731\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.834(0.893\u0026ndash;3.766)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of fever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.791\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.313(0.999\u0026ndash;1.279)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of coughing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.276\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.019(0.985\u0026ndash;1.055)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.833\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.016(0.880\u0026ndash;1.172)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.475\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.053(1.005\u0026ndash;1.104)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.825\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.089(0.906\u0026ndash;1.309)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.556\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.601\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.855\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.355\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.574(0.177\u0026ndash;1.863)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.518\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.413\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.678(0.873\u0026ndash;3.225)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAST\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.933\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.002(0.649\u0026ndash;1.062)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.806\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.943(0.895\u0026ndash;0.994)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.030\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.970(0.882\u0026ndash;1.067)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.980\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.989(0.980\u0026ndash;0.998)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study classified 383 children with MPP into an organic lesion group (17.5%) and a non-organic lesion group through bronchoscopy, investigating the clinical characteristics, laboratory index differences, and independent risk factors of organic lesions between the two groups. The results showed that the incidence of organic lesions (such as moldy secretions, airway stenosis, etc.) in MPP children was 17.5%, which is consistent with the reported incidence of organic airway lesions in MPP (15.2%-20.8%) in previous studies [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This suggests that organic airway lesions are not uncommon in MPP children, and early identification and intervention should be emphasized in clinical practice.\u003c/p\u003e\n\u003ch3\u003eClinical characteristics of organic lesions in children with MPP\u003c/h3\u003e\n\u003cp\u003eThis study found that the proportion of wet rales in children with organic lesions was significantly lower than that in the non-organic lesion group (59.70% vs 77.53%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and the duration of normal body temperature was significantly longer than that in the non-organic lesion group (5.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52 days vs 5.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.60 days, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Wet rales are signs produced by the vibration of exudate in the airway during pulmonary infection, while organic lesions (such as mucus plug obstruction, bronchial mucosal necrosis and sloughing) may lead to airway stenosis or occlusion, obstructing airflow and consequently reducing the auscultation of wet rales [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. These results suggest that for children with MPP who exhibit inconspicuous wet rales, the possibility of organic airway obstruction should be considered to avoid delaying bronchoscopy due to negative auscultation findings. Cough and wheezing are core symptoms of MPP, caused by airway inflammation and spasm induced by mycoplasma infection. Regardless of the presence of organic lesions (such as mucus plugs or stenosis), children may exhibit airway hyperresponsiveness, leading to widespread symptoms with low specificity [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The low incidence of wheezing (0% in the organic lesion group vs 4.11% in the non-organic lesion group) may be related to the small sample size or the fact that organic lesions are primarily characterized by mucus plugs and mucosal necrosis, with airway stenosis not reaching the threshold for wheezing generation.\u003c/p\u003e \u003cp\u003eThe prolonged duration of normal body temperature may be associated with persistent inflammation caused by organic lesions. Organic airway injuries (e.g., mucus plugs) can serve as an inflammatory \"reservoir,\" impeding drug penetration and the clearance of inflammatory factors, thereby leading to prolonged systemic inflammatory responses [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In this study, the duration of normal body temperature in the organic lesion group was 0.79 days longer than that in the non-organic lesion group. Although the absolute difference was not significant, the statistical significance was marked, suggesting that organic lesions may be one of the underlying reasons for the difficulty in controlling inflammation in children with MPP.\u003c/p\u003e \u003cp\u003eAllergic factors may exacerbate MPP symptoms through airway hyperresponsiveness, whereas organic lesions are primarily associated with direct mycoplasma-induced damage, mucus plug formation, and airway remodeling, with allergic immune mechanisms playing a relatively minor role. The proportion of children with a history of allergic diseases in the samples was low (16.14% in the non-organic group and 23.88% in the organic group), which may not have reached the statistical significance threshold [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Cough duration is influenced by multiple factors such as infection control and airway repair. After bronchoscopic interventions (e.g., lavage, mucus plug clearance) in both groups, airway patency improved, and the duration of cough and moist rales may have been homogenized by the intervention measures. The difference in the time to disappearance of moist rales approached the critical value (P\u0026thinsp;=\u0026thinsp;0.056), which may be related to insufficient sample size.\u003c/p\u003e\n\u003ch3\u003eCorrelation between laboratory indices and organic lesions of the MPP airway\u003c/h3\u003e\n\u003cp\u003eLaboratory results demonstrated that all MPP patients, regardless of the presence of organic lesions, exhibited systemic inflammatory responses induced by Mycoplasma infection. Conventional inflammatory markers such as WBC, NC, and CRP were generally elevated during the acute phase, but they lacked specificity for localized organic changes in the airways (e.g., mucus plugs, mucosal necrosis). CRP levels were moderately elevated in both groups (non-organic group: 17.53\u0026thinsp;\u0026plusmn;\u0026thinsp;24.04 mg/L; organic group: 21.96\u0026thinsp;\u0026plusmn;\u0026thinsp;16.80 mg/L), which may be related to the insignificant difference in the degree of inflammation. The levels of DD (1.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88 vs 0.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39) and FDP (4.09\u0026thinsp;\u0026plusmn;\u0026thinsp;7.62 vs 2.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74) were significantly elevated in the organic lesion group, while albumin (39.37,37.1, 41.4) and CK (56.01\u0026thinsp;\u0026plusmn;\u0026thinsp;29.61 vs 80.71\u0026thinsp;\u0026plusmn;\u0026thinsp;72.89) were significantly reduced (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). DD and FDP are sensitive indicators reflecting coagulation system activation. Airway inflammation in MPP patients can activate neutrophils and endothelial cells, releasing inflammatory factors (e.g., TNF-α, IL-6), damaging vascular endothelium, initiating coagulation cascade reactions, and leading to microthrombus formation [13]. Microthrombi can exacerbate airway microcirculatory disturbances, promote mucus plug formation and mucosal necrosis, and subsequently progress to organic lesions. The findings of this study are consistent with those of Li et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e14\u003c/span\u003e], who reported significantly higher levels of D-dimethylpropanediol (DD) in children with mucous plug in the airway (MPP) compared to those without mucous plug. This suggests that coagulation dysfunction may be a key mechanism underlying the organic damage in MPP.\u003c/p\u003e \u003cp\u003eBoth groups of pediatric patients exhibited varying degrees of coagulation activation (e.g., elevated DD and FDP), with platelet (PLT) differences being masked by overall coagulation status. No significant differences were observed in liver function parameters (LDH, AST, ALT) or myocardial enzyme levels, suggesting that the organic lesions primarily affected the airway locally with minimal systemic impact, or that the proportion of pediatric patients with abnormal liver/kidney function in the samples was low [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. No difference in CKMB levels indicated that myocardial injury was not significant in either group.\u003c/p\u003e \u003cp\u003eThe decrease in albumin levels may be associated with inflammatory consumption and impaired hepatic synthesis function. In severe infections, inflammatory factors inhibit hepatic albumin synthesis while enhancing catabolism, leading to hypoalbuminemia [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Conversely, hypoalbuminemia can exacerbate airway mucosal edema and promote the progression of organic lesions. Creatine kinase (CK), primarily localized in skeletal and cardiac muscles, exhibits unclear mechanisms of reduction. This phenomenon may be linked to muscle atrophy or metabolic disturbances caused by prolonged bed rest, requiring further research for confirmation.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eIndependent risk factors for MPP airway organic lesions\u003c/h2\u003e \u003cp\u003eLogistic regression analysis revealed that moist rales (OR\u0026thinsp;=\u0026thinsp;0.302,95% CI: 0.159\u0026ndash;0.575), ALT (OR\u0026thinsp;=\u0026thinsp;0.970,95% CI: 0.882\u0026ndash;1.067), CK (OR\u0026thinsp;=\u0026thinsp;0.989,95% CI: 0.980\u0026ndash;0.998), and follow-up NC (OR\u0026thinsp;=\u0026thinsp;1.053,95% CI: 1.005\u0026ndash;1.104) were independent risk factors for MPP airway organic lesions (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eNegative moist rales (OR\u0026thinsp;\u0026lt;\u0026thinsp;1) suggest that it may be a \"negative predictive sign\" of organic lesions. As previously mentioned, airway obstruction (e.g., mucus plugs) can reduce the conduction of moist rales. In clinical practice, if a child with MPP exhibits no obvious moist rales upon pulmonary auscultation but still presents with cough and dyspnea, organic lesions should be highly suspected [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe elevated neutrophil count (OR\u0026thinsp;\u0026gt;\u0026thinsp;1) in follow-up visits indicates that persistent neutrophil-mediated inflammation is closely associated with organic lesions. During MPP-induced inflammation, neutrophils damage airway mucosa by releasing elastase and myeloperoxidase, leading to mucosal desquamation and granulation tissue hyperplasia, which subsequently results in airway stenosis [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The findings of this study support the role of neutrophils as key effector cells in MPP-induced airway injury, suggesting that controlling neutrophil infiltration may reduce the occurrence of organic lesions.\u003c/p\u003e \u003cp\u003eThe clinical significance of decreased ALT and CK remains unclear, potentially related to hepatic compensation or muscle metabolic inhibition, requiring further investigation with additional metabolic markers.\u003c/p\u003e \u003cp\u003eIn the univariate analysis, covariates with P-values\u0026thinsp;\u0026lt;\u0026thinsp;0.2, including gender, history of allergic diseases, D-dimer (DD), and fibrinogen degradation products (FDP), were included in the regression model. However, these factors showed no statistical significance in the multivariate analysis. Potential reasons include: multicollinearity among variables; reduced statistical power due to insufficient sample size; and differences observed in some covariates in the univariate analysis being attributed to confounding effects [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eClinical Significance and Limitations\u003c/h3\u003e\n\u003cp\u003eThis study is the first to reveal the association between moist rales, follow-up neutrophil count (NC), and other indicators with airway organic lesions in children with Mycoplasma pneumoniae pneumonia (MPP), providing a clinical basis for early identification of high-risk children. For MPP children with negative moist rales but elevated follow-up NC, early bronchoscopy is recommended to promptly remove mucus plugs and relieve airway obstruction, thereby improving prognosis.\u003c/p\u003e \u003cp\u003eThis study was designed as a single-center retrospective study, which has limitations such as limited sample size, absence of quantitative analysis of pathogen load and treatment regimens, and lack of long-term follow-up data. Therefore, it is not possible to evaluate the impact of organic lesions on the long-term pulmonary function of pediatric patients. Future multicenter prospective studies are needed to further explore the dynamic evolution patterns of organic lesions and develop targeted intervention strategies.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study demonstrated that the incidence of airway organic lesions in children with Mycoplasma pneumoniae pneumonia (MPP) was 17.5%. Negative moist rales, prolonged duration of normal body temperature, elevated D-dimer (DD) and fibrinogen-dependent protein (FDP), as well as decreased albumin and creatine kinase (CK) levels, may indicate the risk of airway organic lesions. Logistic regression analysis confirmed that moist rales (OR\u0026thinsp;=\u0026thinsp;0.302) and neutrophil count (NC) at follow-up visits (OR\u0026thinsp;=\u0026thinsp;1.053) were independent risk factors. The clinical implications suggest that for MPP children with mild moist rales but elevated NC at follow-up, airway organic obstruction (e.g., mucus plugs or strictures) should be suspected, and early bronchoscopy is recommended to remove obstructions and improve inflammatory control. Concurrently, attention should be paid to changes in coagulation function (DD, FDP) and albumin/CK levels to aid in the early identification of high-risk children. Clinicians should prioritize MPP children with abnormal indicators and perform bronchoscopy as early as possible to improve prognosis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eMPP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003emycoplasma pneumoniae pneumonia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003ecommunity-acquired pneumonia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eMycoplasma pneumoniae\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eBO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003ebronchiolitis obliterans\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eWBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eWhite blood cell count\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eNeutrophil count\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eLC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eLymphocyte count\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eMC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eMonocyte count\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eEC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eEosinophil count\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003ePLT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003ePlatelet\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCRP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eC-reactive protein\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eESR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eErythrocyte sedimentation rate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eDD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eD-dimer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eFDP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eFibrin degradation products\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eLDH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eLactate dehydrogenase\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eALT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAlanine aminotransferase\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAspartate aminotransferase\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCreatine kinase\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCK-MB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eCreatine kinase isoenzyme\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eAll the children involved in the study obtained the informed consent from their parents, and this research has been approved by the Ethics Committee of Shunyi District Hospital in Beijing (Approval Number: 2026-L-005).This research complies with the relevant requirements of the Helsinki Declaration.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eThe data used in this study does not include personal details, pictures or videos.All the clinical data in this study have been anonymized. Therefore, this study does not apply for the publication of consent forms.\u003c/p\u003e\n\u003cp\u003eAvailability of Data and Materials\u003c/p\u003e\n\u003cp\u003eAll the data in this study were derived from the inpatient medical record system of the Shunyi District Hospital in Beijing. If you need to access this database, please contact Director Xvli Kang at the email address: [email protected]. In addition, the data used in this research has been compiled into a spreadsheet and has been uploaded in the relevant files.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThe children in this study were selected from those undergoing routine diagnosis and treatment for mycoplasma pneumonia; the study utilized conventional clinical examination data; there were no additional costs and no funding support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e[Respiratory Group of the Pediatrics Branch of the Chinese Medical Association, Editorial Board of Chinese Journal of Pediatrics. Guidelines for the Management of Community-Acquired Pneumonia in Children (2024 Edition) [J]. Chinese Journal of Pediatrics, 2023,61(3):167-175].\u003c/li\u003e\n\u003cli\u003eWaites KB, Atkinson TP, Balish MF. Mycoplasma pneumoniae from the respiratory tract and beyond: more than an airway pathogen[J]. Clin Microbiol Rev, 2017, 30(3): 747-809.\u003c/li\u003e\n\u003cli\u003e[Zhao SY, Liu HM, Lu Q, Liu XC, Hong JG, Liu EM, Zou YX, Yang M, Chen ZM, Zhang HL, Zhao DY, Zhang XB, Yin Y, Dong XY, Lu XX, Liu JR, Chen LN. [Interpretation of key points in diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children (November 2023)]. Zhonghua Er Ke Za Zhi. 2024 Feb 2;62(2):108-113. ].\u003c/li\u003e\n\u003cli\u003eZhang H, Yang J, Zhao W, Zhou J, He S, Shang Y, Cheng Q. Clinical features and risk factors of plastic bronchitis caused by refractory Mycoplasma pneumoniae pneumonia in children: a practical nomogram prediction model. Eur J Pediatr. 2023 Mar;182(3):1239-1249.\u003c/li\u003e\n\u003cli\u003e[Wu X, Lu W, Liu W, Ren Y, Fan S, Xu Y, Zhang R, Liu X, Wang M, Wang T, Zhang X, He S, Li S. Predictive value of an early comprehensive assessment model for refractory mycoplasma pneumoniae pneumonia and internal validation. BMC Infect Dis. 2025 May 24;25(1):744. ].\u003c/li\u003e\n\u003cli\u003eSun Y, Li P, Jin R, Liang Y, Yuan J, Lu Z, Liang J, Zhang Y, Ren H, Zhang Y, Chen J, Huang Y, Lin C, Li Y, Zhou J, Wang X, Li Y, Huang S, Xu J, Qin T. Characterizing the epidemiology of Mycoplasma pneumoniae infections in China in 2022-2024: a nationwide cross-sectional study of over 1.6 million cases. Emerg Microbes Infect. 2025 Dec;14(1):2482703.\u003c/li\u003e\n\u003cli\u003eMu S, Zhai J, Guo Y, Huang B, Zou Y. Prediction of risk factors of plastic bronchitis in children with severe Mycoplasma pneumoniae pneumonia. Biomed Eng Online. 2025 Jun 21;24(1):75. \u003c/li\u003e\n\u003cli\u003eZheng Y, Mao G, Dai H, Li G, Liu L, Chen X, Zhu Y. Early predictors of delayed radiographic resolution of lobar pneumonia caused by Mycoplasma pneumoniae in children: a retrospective study in China. BMC Infect Dis. 2024 Apr 19;24(1):414. \u003c/li\u003e\n\u003cli\u003eLi YT, Zhang J, Wang MZ, Ma YM, Zhi K, Dai FL, Li SJ. Changes in coagulation markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for Mycoplasma severity. Ital J Pediatr. 2023 Oct 20;49(1):143. \u003c/li\u003e\n\u003cli\u003eWaites KB, Talkington DF. Mycoplasma pneumoniae infections in children[J]. Clin Microbiol Rev, 2004, 17(4):697-728.\u003c/li\u003e\n\u003cli\u003eKang D, Yun KW, Lee T, Cho EY, Eun BW, Lee JK, Kim YJ, Kim DR, Shin A, Kang HM, Kim YJ, Kim DH, Choi YJ, Lee H, Cho Y, Kwak BO, Jo KJ, Choi JH, Choi EH, Park SE. Treatment modalities for fever duration in children with Mycoplasma pneumoniae pneumonia. Sci Rep. 2025 Apr 28;15(1):14860. \u003c/li\u003e\n\u003cli\u003ede Groot RCA, Streng BMM, Bont LJ, Meyer Sauteur PM, van Rossum AMC. Resurgence of Mycoplasma pneumoniae infections in children: emerging challenges and opportunities. Curr Opin Infect Dis. 2025 Oct 1;38(5):468-476. [13].Chen L, Yang X, Liu Y, et al. Coagulation dysfunction in children with refractory Mycoplasma pneumoniae pneumonia[J]. Thromb Res, 2019, 183: 132-137.\u003c/li\u003e\n\u003cli\u003eYue Y, Lian T, Kang L, Liu S, Geng W, Xu M. D-dimer serves as predictor of plastic bronchitis or necrotizing pneumonia in children with Mycoplasma pneumoniae pneumonia. Front Pediatr. 2025 Jul 15;13:1604253. \u003c/li\u003e\n\u003cli\u003eEsposito S, Blasi F, Arosio C, Fioravanti L, Fagetti L, Droghetti R, Tarsia P, Allegra L, Principi N. Importance of acute Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with wheezing. Eur Respir J. 2000 Dec;16(6):1142-6. \u003c/li\u003e\n\u003cli\u003eQi R, Yang Q, Li H, Wan Z, Ruan S. Pulmonary tuberculosis versus Mycoplasma pneumoniae pneumonia in children: A retrospective analysis of clinical and imaging characteristics. Medicine (Baltimore). 2025 Nov 14;104(46):e45990.\u003c/li\u003e\n\u003cli\u003eXu X, Zhang D, Zhang H, Wolters PJ, Killeen NP, Sullivan BM, Locksley RM, Lowell CA, Caughey GH. Neutrophil histamine contributes to inflammation in mycoplasma pneumonia. J Exp Med. 2006 Dec 25;203(13):2907-17.\u003c/li\u003e\n\u003cli\u003ePreisser JS, Das K, Benecha H, Stamm JW. Logistic regression for dichotomized counts. Stat Methods Med Res. 2016 Dec;25(6):3038-3056. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pulmonary-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pulm","sideBox":"Learn more about [BMC Pulmonary Medicine](http://bmcpulmmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pulm/default.aspx","title":"BMC Pulmonary Medicine","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mycoplasma pneumoniae pneumonia, children, bronchial organic lesions, moist rales, neutrophil, risk factors","lastPublishedDoi":"10.21203/rs.3.rs-8771843/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8771843/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjective: To investigate the incidence, clinical features, laboratory indices and independent risk factors of bronchial organic lesions in children with Mycoplasma pneumoniae pneumonia (MPP) after standard treatment.\u003c/p\u003e\n\u003cp\u003eMethods: According to bronchoscopy results,383 cases of MPP were divided into organic lesion group and non-organic lesion group. The clinical characteristics and laboratory indexes of the two groups were compared. The independent risk factors of organic lesions were analyzed by Logistic regression.\u003c/p\u003e\n\u003cp\u003eResults: The incidence of bronchial organic lesions in children with MPP was 17.5%. Compared with the non-organic lesion group, the proportion of moist rales in the organic lesion group was significantly lower (59.70% vs 77.53%, P\u0026lt;0.05), and the duration of normal body temperature was significantly prolonged (5.85±2.52 days vs 5.06±2.60 days, P\u0026lt;0.05). In laboratory indicators, the levels of D-dimer (DD) and fibrinogen degradation product (FDP) were significantly elevated, while the levels of albumin and creatine kinase (CK) were significantly reduced in the organic lesion group (all P\u0026lt;0.05). At follow-up, the white blood cell count (WBC) in the organic lesion group was significantly higher than that in the non-organic lesion group (P\u0026lt;0.05). Logistic regression analysis showed that negative moist rales (OR=0.302,95% CI: 0.159-0.575) and neutrophil count (NC) at follow-up (OR=1.053,95% CI: 1.005-1.104) were independent risk factors for bronchial organic lesions in children with MPP (all P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eConclusion: The incidence of bronchial organic lesions in children with MPP is about 17.5%. The negative sputum crackles and elevated NC in follow-up visits are independent risk factors. Clinicians should pay attention to such children and perform bronchoscopy as early as possible to improve prognosis.\u003c/p\u003e","manuscriptTitle":"Logistic regression analysis of influencing factors of bronchial lesions in children with Mycoplasma pneumonia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-13 09:24:10","doi":"10.21203/rs.3.rs-8771843/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-03-09T06:49:20+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-04T12:12:05+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-12T17:52:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-12T01:56:20+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pulmonary Medicine","date":"2026-02-12T01:51:37+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pulmonary-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pulm","sideBox":"Learn more about [BMC Pulmonary Medicine](http://bmcpulmmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pulm/default.aspx","title":"BMC Pulmonary Medicine","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3fe7b6c4-9c79-4b8a-a3c7-6d92500a7d3f","owner":[],"postedDate":"March 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-13T09:24:10+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-13 09:24:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8771843","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8771843","identity":"rs-8771843","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}