Although predictive accuracy slightly decreased in the test set compared to the training set, the model still retained satisfactory predictive performance, indicating its potential generalizability.<h4>Conclusion</h4>The prediction model incorporating ESR, CD4<sup>+</sup> T cells, NK cells, IL-4, duration of fever, and pleural effusion showed good predictive value for NP in children with RMPP. This evidence concerns the gene ESR1 and Pleural effusion.