Department of Respiratory, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Pediatric Research Institute, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China.
Children's Clinical College of Tianjin Medical University, Tianjin, China.
Immun Inflamm Dis. 2024 Aug;12(8):e1373. doi: 10.1002/iid3.1373.
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.
Data on preschool children with PB during HBoV1 or MP infection were collected, comparing MP-PB to severe Mycoplasma pneumoniae pneumonia.
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.
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.
本研究旨在探讨人博卡病毒 1 型（HBoV1）-塑料性细支气管炎（PB）、肺炎支原体（MP）相关性塑料性细支气管炎（PB）和 MP-非典型性 PB 患儿的临床和实验室特征，重点关注炎症、凝血和支气管镜需求。
收集了 HBoV1 或 MP 感染相关的 PB 患儿的临床资料，比较了 MP-PB 与重症肺炎支原体肺炎的差异。
与 MP-PB 组相比，HBoV1-PB 组患儿年龄较小，临床症状明显较轻，但白细胞计数较高（p=0.028）。MP-PB 组纤维蛋白原（p=0.045）和 D-二聚体（p<0.001）水平显著升高。与 MP-NPB 组相比，MP-PB 组患儿的 D-二聚体水平仍然较高，炎症指标如 C 反应蛋白、降钙素原、乳酸脱氢酶和白细胞介素-6 也明显升高，与 MP-NPB 组相比差异有统计学意义。MP-PB 组在较低肺叶中更易出现塑料性支气管铸型（p=0.016），且支气管肺泡灌洗液细胞学中中性粒细胞占优势。此外，MP-PB 组患儿倾向于接受更多次的支气管镜检查。
本研究明确了 HBoV1 和 MP 引起的儿童塑料性细支气管炎之间的关键差异，提示 HBoV1 引起的炎症在较小年龄儿童中更为轻微，而 MP 则与严重炎症和凝血反应相关，这有助于指导临床诊断和治疗。
