Analysis of risk factors for plastic bronchitis in children with refractory Mycoplasma pneumoniae pneumonia

Objective To explore the risk factors for refractory Mycoplasma pneumoniae pneumonia (RMPP) in patients with plastic bronchitis. Methods A retrospective analysis was performed in RMPP children receiving bronchoscopy admitted to the Children′s Hospital of Soochow University from January 2013 to December 2017.According to the bronchoscopic findings, the patients were divided into plastic bronchitis group and non-plastic bronchitis group.The children′s gender, age, clinical manifestations, laboratory findings, imaging features, bronchoscopy findings and treatment were collected.Logistic regression was used to analyze the risk factors for plastic bronchitis in children with RMPP. Results A total of 198 children with RMPP were enrolled in the study, including 151 (76.3%) children in the non-plastic bronchitis group and 47 (23.7%) children in the plastic bronchitis group.There was no difference in the ratios of gender, age, proportion of fever, cough and wheezing between the 2 groups(all P>0.05). Compared with the non-plastic bronchitis group, children stayed longer at hospital in the plastic bronchitis group [13(8, 23) d vs. 9(7, 19) d](P<0.01). The longer the duration of fever (OR=6.10, 95% CI: 1.60-23.50), the lower the percen-tage of lymphocytes (L%) (OR=0.90, 95% CI: 0.81-0.98), and the higher the lactate dehydrogenase (LDH) (OR=1.03, 95% CI: 1.01-1.08), the higher the C reactive protein (CRP) (OR=1.10, 95% CI: 1.01-1.16) was, which was an independent risk factor for morphine bronchitis in RMPP (all P<0.05). The duration of fever, L%, CRP and LDH were 11 days, 30%, 50 mg/L and 550 U/L, respectively. Conclusions The duration of fever ≥11 days, the L% 550 U/L, and CRP>50 mg/L ware independent risk factors for bronchitis in RMPP.