Influencing Factors of Bronchiolitis Obliterans in Children with Mycoplasma pneumoniae Pneumonia Complicated with Wheezing and the Early Predictive Value of Serum Blood Indicators for the Risk of Its Occurrence

XU Qingrong; WANG Lihong; CAO Xiaomei; ZHANG Yan

doi:10.3969/j.issn.1004-437X.2026.06.015

Abstract：Objective To investigate the influencing factors of bronchiolitis obliterans(BO)in children with Mycoplasma pneumoniae pneumonia(MPP)and wheezing,and the early predictive value of combined detection of interleukin-8(IL-8),interleukin-17(IL-17)and vascular endothelial growth factor(VEGF)at admission for BO risk.Methods Prospective cohort study method was applied,one hundred and forty-nine children with MPP and wheezing admitted to the Third Affiliated Hospital of Zhengzhou University from January 2023 to December 2024 were selected.The children were divided into BO group(31 cases)and non-BO group(118 cases)according to whether BO occurred.The clinical data,serum IL-8,IL-17 and VEGF levels at admission were compared between the two groups.Multivariate logistic regression equation was used to analyze the influencing factors of BO in children with MPP.Receiver operating characteristic(ROC)curve was used to analyze the early predictive value of IL-8,IL-17,and VEGF levels at admission alone and combination for predicting the risk of BO in children with MPP and wheezing.Results The proportion of hypoxemia,glucocorticoid(＞2 mg·kg-1)and diffuse bronchiolitis in the BO group were higher than those in the non-BO group(P＜0.05).The IL-8,IL-17 and VEGF levels at admission in the BO group were higher than those in the non-BO group(P＜0.05).Multivariate logistic regression analysis showed that hypoxemia,glucocorticoids(＞2 mg·kg-1),diffuse bronchiolitis,and the IL-8,IL-17,and VEGF levels at admission were independent influencing factors for the occurrence of BO in children with MPP and wheezing(P＜0.05).After adjusting for collinearity indicators such as hypoxemia,glucocorticoids(＞2 mg·kg-1),and diffuse bronchiolitis,multiple logistic regression analysis showed that IL-8,IL-17,and VEGF levels at admission still were independent influencing factors for the occurrence of BO in children with MPP and wheezing(P＜0.05).ROC curve showed that the area under the curve(AUC)value of the combined prediction of serum IL-8,IL-17,and VEGF levels at admission for the risk of BO in children with MPP and wheezing was higher than the three factors predicted separately(P＜0.05).Conclusion The serum IL-8,IL-17,and VEGF levels at admission are independent influencing factors for the occurrence of BO in children with MPP and wheezing,and their combined detection has high early predictive value for the risk of BO and can be used as serum markers to predict BO and provide decision-making guidance for early clinical risk stratification and preventive intervention.