Mu Shiyin, Zhai Jia, Guo Yongsheng, Huang Bing, Zou Yingxue
Department of Respiratory of Ma-Chang, Tianjin Children's Hospital, Tianjin University Children's Hospital, 225 Machang Road, Tianjin, 300074, China.
Children's Hospital, Tianjin University, 225 Machang Road, Tianjin, 300074, China.
Sci Rep. 2025 Aug 26;15(1):31406. doi: 10.1038/s41598-025-15333-w.
Early diagnosis of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children presents significant clinical challenges. Emerging evidence suggests that circ_0054633 may serve as a promising diagnostic biomarker for pulmonary infections. We developed a comprehensive nomogram integrating circ_0054633 expression with clinical features to evaluate its predictive efficacy for early RMPP diagnosis in children. This retrospective study analyzed 244 children with Mycoplasma pneumoniae pneumonia (MPP) admitted to Tianjin Children's Hospital during 2023. Multivariate analysis identified six independent predictors: elevated circ_0054633 (OR = 6.28, 95% CI: 2.73-14.47), prolonged fever duration (OR = 1.50, 95% CI: 1.24-1.81), hypoxemia (OR = 10.64, 95% CI: 2.75-41.20), extrapulmonary complications (OR = 2.95, 95% CI: 1.17-7.40), elevated IL-6 (OR = 1.02, 95% CI: 1.00-1.03), and atelectasis (OR = 3.16, 95% CI: 1.25-8.00). The nomogram demonstrated excellent discrimination (AUC = 0.920) and calibration. RMPP patients required longer hospitalization (median 9 vs. 7 days, P < 0.001) and more interventions. The circ_0054633-based nomogram, incorporating clinical predictors, exhibits strong predictive value for RMPP in children. Serum circ_0054633 shows promise as a novel diagnostic biomarker for RMPP.
儿童难治性肺炎支原体肺炎（RMPP）的早期诊断面临重大临床挑战。新出现的证据表明，circ_0054633可能是肺部感染的一个有前景的诊断生物标志物。我们开发了一种综合列线图，将circ_0054633表达与临床特征相结合，以评估其对儿童早期RMPP诊断的预测效能。这项回顾性研究分析了2023年期间入住天津市儿童医院的244例肺炎支原体肺炎（MPP）患儿。多因素分析确定了6个独立预测因素：circ_0054633升高（OR = 6.28，95%CI：2.73 - 14.47）、发热持续时间延长（OR = 1.50，95%CI：1.24 - 1.81）、低氧血症（OR = 10.64，95%CI：2.75 - 41.20）、肺外并发症（OR = 2.95，95%CI：1.17 - 7.40）、IL-6升高（OR = 1.02，95%CI：1.00 - 1.03）和肺不张（OR = 3.16，95%CI：1.25 - 8.00）。该列线图显示出良好的区分度（AUC = 0.920）和校准度。RMPP患者需要更长的住院时间（中位数9天对7天，P < 0.001）和更多的干预措施。基于circ_0054633的列线图结合临床预测因素，对儿童RMPP具有很强的预测价值。血清circ_0054633有望成为RMPP的一种新型诊断生物标志物。
