目的 探讨肺炎支原体肺炎（Mycoplasmal pneumoniae pneumonia, MPP）患儿血清中肝素结合蛋白（heparin‑bindingprotein,HBP）及其他临床指标与支气管镜下病变严重程度的关系，以了解它们在指导临床诊疗中的潜在价值。 方法 回顾性分析2023年12月—2025年9月徐州医科大学附属医院儿科收治的248例MPP急性期患儿的病历资料，根据支气管镜下病变严重程度分为重度镜下组（96例）和轻度镜下组（152例）。收集两组患儿的临床资料，进行统计学分析，将有统计学意义的临床指标与HBP水平进行相关性分析，并采用受试者操作特征曲线分析HBP对MPP支气管镜下病变严重程度的预测价值。 结果 重度镜下组的HBP水平高于轻度镜下组（中位数：36.2 ng/mL vs 22.8 ng/mL，P<0.001）。与轻度镜下组相比，重度镜下组热峰更高，发热持续时间更长，Ｃ反应蛋白（C‑reactive protein, CRP）、Ｄ‑二聚体（D‑dimer, DD）、乳酸脱氢酶（lactate dehydrogenase, LDH）等炎症指标也更高（均P<0.05）。HBP水平与发热持续时间及炎症指标CRP、DD、LDH、中性粒细胞比例（neutrophil percentage, N%）均呈正相关（r_s 分别为0.256、0.302、0.635、0.327、0.140，均P<0.05）。HBP、发热持续时间、CRP、DD、LDH、N%预测支气管镜下病变严重程度的曲线下面积分别为0.850、0.681、0.784、0.832、0.780、0.642。当HBP水平的截断值为28.9 ng/mL时，HBP对支气管镜下病变严重程度预测的灵敏度和特异度分别为80.2%、79.6%。 结论 HBP及CRP、DD、LDH等临床指标与MPP患儿镜下严重程度显著相关，HBP对支气管镜下病变严重程度的预测效能较好。

Objective To investigate the correlation between serum heparin-binding protein (HBP) and other clinical indicators with the bronchoscopic lesion severity in children with Mycoplasma pneumoniae pneumonia (MPP), in order to understand their potential value in guiding diagnosis and treatment. Methods A retrospective analysis was conducted on 248 children with acute MPP admitted to the Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University from December 2023 to September 2025. Patients were divided into severe lesion group (n=96) and mild lesion group (n=152) based on bronchoscopic findings. Clinical data including fever peak and duration, serum levels of HBP, C-reactive protein (CRP), D-dimer (DD), lactate dehydrogenase (LDH), and neutrophil percentage (N%) were collected. Statistical analyses were performed between groups, followed by correlation analysis between HBP levels and significant clinical indicators. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of HBP and other indicators for bronchoscopic lesion severity. Results HBP levels in the severe lesion group were significantly higher than those in the mild lesion group (median: 36.2 ng/mL vs 22.8 ng/mL, P<0.001). The severe lesion group also exhibited higher peak fever, longer fever duration, and elevated CRP, DD, and LDH levels (all P<0.05). HBP showed positive correlations with fever duration, CRP, DD, LDH, and N% (r_s =0.256, 0.302, 0.635, 0.327, 0.140, respectively; all P<0.05). ROC analysis demonstrated that HBP had the highest area under the curve (AUC=0.850) for predicting bronchoscopic lesion severity, followed by DD (AUC=0.832), CRP (AUC=0.784), LDH (AUC=0.780), fever duration (AUC=0.681), and N% (AUC=0.642). At a cut-off value of 28.9 ng/mL, HBP predicted severe lesions with 80.2% sensitivity and 79.6% specificity. Conclusions Serum HBP, CRP, DD, and LDH are significantly associated with the microscopic severity of bronchoscopic lesions in children with MPP. HBP shows superior predictive performance and may provide valuable clinical guidance for assessing lesion severity.