Analysis of risk factors for recurrence in children with asthmatic bronchopneumonia during remission and discussion on the therapeutic effect of diprophylline combined with budesonide

Background: Asthmatic bronchopneumonia (ABP) is a common lower respiratory tract infection in infants and young children. Although most of the children have a good prognosis, more than 30% of the cases still face the risk of recurrence during the remission period and are prone to progress to airway hyperresponsiveness disease. Objective: The aim of this study is to evaluate the efficacy and safety of dihydroxypropylline (DPL) combined with budesonide (BUD) in the treatment of pediatric ABP, and to analyze the independent risk factors for recurrence during remission, so as to provide a basis for clinical prevention and treatment. Methods: This randomized controlled trial evaluated DPL combined with BUD for ABP in 80 children (40 per group) treated for 7 days. The experimental group received DPL (0.1g/day IV) plus BUD (1mg twice daily by nebulization); controls received DPL alone. Primary outcomes included clinical efficacy and inflammatory markers. Results: The combination therapy showed higher total efficacy (95.0% vs. 85.0%, p=0.136) and significantly reduced inflammatory markers (WBC: 6.96±1.45 vs. 9.78±1.09×109/L, p<0.001). Multivariate analysis identified breastfeeding duration ?3 months (OR=2.64, 95%CI: 1.16-6.91), malnutrition (OR=2.54, 95%CI: 1.14-5.54) and tobacco exposure (OR=3.84, 95%CI: 1.65-6.72) as independent recurrence risk factors. Conclusion: DPL combined with BUD can quickly relieve the clinical symptoms and reduce the level of inflammation in children with ABP, with good safety. More attention should be paid to breastfeeding support, environmental tobacco control and nutritional intervention to reduce the risk of relapse during remission.