Xue Jiayi, Fan Yinghong, Luo Ronghua, Duan Yaping, Ai Tao, Wang Li
Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Transl Pediatr. 2025 May 30;14(5):939-946. doi: 10.21037/tp-2025-103. Epub 2025 May 27.
pneumonia (MPP) can cause lung function damage; however, few studies have examined the correlation between airway resistance and MPP severity. This study aimed to investigate changes in airway resistance related to severe MPP (SMPP) in children and evaluate its role in assessing disease severity.
A total of 96 children with MPP, admitted to Chengdu Women's and Children's Center Hospital from December 2022 to December 2023, were recruited for the study. The children were allocated to the mild MPP (MMPP) group (n=39) and the SMPP group (n=57) based on disease severity. Indices derived from impulse oscillometry (IOS) were compared, and receiver operating characteristic (ROC) curves were generated to assess the predictive value of various indicators for SMPP.
The results revealed significant increases in respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), reactance at 5 Hz (X5), and resonant frequency (Fres) in the SMPP group compared to the MMPP group (P<0.05). Compared to the children in the MMPP group, those in the SMPP group had a significantly longer hospital length of stay, and a higher proportion were admitted to the intensive care unit (ICU) and received mechanical ventilation (P<0.05). A positive correlation was found between MPP severity and R5, R20, X5, Fres, and hospital length of stay, of which R5 showed the strongest correlation. The ROC curve analysis indicated that R5 was the most effective predictor of SMPP, with an area under the curve (AUC) indicating good predictive ability [R5 > R20 > hospital length of stay > X5 (0.70)]. R5 had the highest predictive value for SMPP, with a sensitivity of 82.46%, a specificity of 87.18%, a cut-off value of 123.80%, a positive predictive value (PPV) of 90.38%, and a negative predictive value (NPV) of 77.27%.
The airway resistance of the children with SMPP was significantly higher than that of the children with MMPP. The primary increase was observed in small airway resistance, which might be accompanied by an increase in large airway resistance, along with a decrease in lung compliance. R5, R20, and X5 were found to be correlated with the severity of MPP, indicating that IOS is a valuable tool for assessing MPP severity.
肺炎支原体肺炎（MPP）可导致肺功能损害；然而，很少有研究探讨气道阻力与MPP严重程度之间的相关性。本研究旨在调查儿童重症MPP（SMPP）相关的气道阻力变化，并评估其在评估疾病严重程度中的作用。
选取2022年12月至2023年12月在成都市妇女儿童中心医院住院的96例MPP患儿进行研究。根据疾病严重程度将患儿分为轻症MPP（MMPP）组（n = 39）和SMPP组（n = 57）。比较脉冲振荡法（IOS）得出的指标，并绘制受试者工作特征（ROC）曲线，以评估各项指标对SMPP的预测价值。
结果显示，与MMPP组相比，SMPP组在5 Hz时的呼吸阻力（R5）、20 Hz时的呼吸阻力（R20）、5 Hz时的电抗（X5）和共振频率（Fres）显著增加（P < 0.05）。与MMPP组患儿相比，SMPP组患儿的住院时间明显更长，入住重症监护病房（ICU）并接受机械通气的比例更高（P < 0.05）。发现MPP严重程度与R5、R20、X5、Fres和住院时间呈正相关，其中R5的相关性最强。ROC曲线分析表明，R5是SMPP最有效的预测指标，曲线下面积（AUC）显示出良好的预测能力[R5 > R20 > 住院时间 > X5（0.70）]。R5对SMPP的预测价值最高，灵敏度为82.46%，特异度为87.18%，截断值为123.80%，阳性预测值（PPV）为90.38%，阴性预测值（NPV）为77.27%。
SMPP患儿的气道阻力明显高于MMPP患儿。主要增加的是小气道阻力，可能伴有大气道阻力增加，同时肺顺应性降低。发现R5、R20和X5与MPP严重程度相关，表明IOS是评估MPP严重程度的有价值工具。
