背景:这项研究调查了人类博卡病毒1型(HBoV1)-塑料细支气管炎(PB)的临床和实验室特征,儿童肺炎支原体(MP)相关的塑料支气管炎(PB)和MP-NPB,突出炎症,凝血,和支气管镜的需要。
方法:收集在HBoV1或MP感染期间患有PB的学龄前儿童的数据,比较MP-PB与重症肺炎支原体肺炎。
结果:与MP-PB组相比,HBoV1-PB组,对于年幼的孩子,临床症状明显减轻,但白细胞计数较高(p=.028)。MP-PB组表现出显著升高的纤维蛋白原(p=.045)和d-二聚体水平(p<.001)。当对比MP-PB与MP-NPB基团时,MP-PB组患儿D-二聚体水平较高,C反应蛋白等炎症指标升高,降钙素原,乳酸脱氢酶,和白细胞介素6,与MP-NPB组相比显着升高。MP-PB在下叶中显示出更高的可塑性支气管管型患病率(p=.016),并且在BALF细胞学中嗜中性粒细胞占优势。此外,MP-PB组的儿童倾向于接受更多的支气管镜检查.
结论:这项研究确定了由于HBoV1和MP引起的儿童可塑性支气管炎的关键差异,强调HBoV1的温和炎症在年轻的孩子和MP的联系严重的炎症和凝血反应,指导临床诊断和治疗。
BACKGROUND: This study investigated clinical and laboratory characteristics of human bocavirus type 1 (HBoV1)-plastic bronchiolitis (PB), Mycoplasma pneumoniae (MP)-associated plastic bronchitis (PB) and MP-NPB in children, highlighting inflammation, coagulation, and bronchoscopic needs.
METHODS: Data on preschool children with PB during HBoV1 or MP infection were collected, comparing MP-PB to severe Mycoplasma pneumoniae pneumonia.
RESULTS: Compared with the MP-PB group, the HBoV1-PB group, with younger children, had significantly milder clinical symptoms but higher WBC counts (p = .028). The MP-PB group exhibited notably elevated Fibrinogen (p = .045) and d-dimer levels (p < .001). When contrasting the MP-PB with the MP-NPB group, children in MP-PB group still had higher levels of d-dimer and increased inflammatory indicators such as C-reactive protein, procalcitonin, lactate dehydrogenase, and interleukin-6, which were significantly elevated compared with the MP-NPB group. MP-PB showed a higher prevalence of plastic bronchial casts in lower lobes (p = .016) and a dominance of neutrophils in BALF cytology. Additionally, children in the MP-PB group tended to undergo a greater number of bronchoscopies.
CONCLUSIONS: This study identifies key differences in plastic bronchitis in children due to HBoV1 and MP, highlighting HBoV1\'s milder inflammation in younger kids and MP\'s link to severe inflammatory and coagulation responses, guiding clinical diagnosis and treatment.