目的 探讨儿童肺炎支原体肺炎（Mycoplasma pneumoniae pneumonia, MPP）反复发生塑型性支气管炎（plastic bronchitis, PB）的危险因素。 方法 回顾性分析2023年7月—2025年1月甘肃省妇幼保健院收治的由MPP致PB并接受支气管镜检查患儿的临床资料。根据PB发生次数将患儿分为单次PB组和反复PB组。分析MPP患儿反复发生PB的危险因素，并评估各指标的诊断效能。 结果 共纳入264例MPP致PB患儿，其中单次PB组188例（71.2%），反复PB组76例（28.8%）。多因素logistic回归分析显示，血清白蛋白下降、肺不张、首次支气管镜术72 h后仍发热与MPP反复发生PB密切相关（P<0.05）。受试者操作特征曲线分析显示，三者联合预测MPP反复发生PB的灵敏度为82.9%，特异度为61.7%，曲线下面积为0.777（95%CI：0.714~0.839），高于各单项指标的预测价值（P<0.05）。 结论 当MPP合并PB者出现血清白蛋白下降、合并肺不张、首次支气管镜术72 h后仍发热时，应警惕反复PB的发生，需及时进行再次或多次支气管镜术治疗。

Objective To identify risk factors for recurrent plastic bronchitis (PB) among children with Mycoplasma pneumoniae pneumonia (MPP). Methods The clinical data of children with MPP complicated by PB who underwent bronchoscopy at Gansu Province Maternity and Child Health Hospital between July 2023 and January 2025 were retrospectively analyzed. Patients were grouped into a single-episode PB group and a recurrent PB group according to the number of PB episodes. Multivariable logistic regression was used to identify risk factors for recurrent PB. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of individual and combined predictors. Results A total of 264 children were included; 188 (71.2%) had a single episode of PB and 76 (28.8%) had recurrent PB. Multivariable logistic regression analysis showed that decreased serum albumin, atelectasis, and fever persisting beyond 72 hours after the initial bronchoscopy were significantly associated with recurrent PB (all P<0.05). The combination of these predictors yielded a sensitivity of 82.9%, specificity of 61.7%, and an area under the ROC curve of 0.777 (95%CI: 0.714-0.839), outperforming any single predictor (P<0.05). Conclusions In children with MPP complicated by PB, decreased serum albumin, the presence of atelectasis, and fever persisting beyond 72 hours after the initial bronchoscopy are associated with an increased risk of PB recurrence. In such cases, early repeat or multiple bronchoscopic interventions should be considered.