外周血NLR与PLR对儿童完全型川崎病冠状动脉损伤的预测分析

Prediction Analysis of NLR and PLR for the Development of Coronary Artery Lesions in Patients with Complete Kawasaki Disease

目的探讨中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)预测完全型川崎病(CKD)患儿冠状动脉损伤(CAL)的价值。方法回顾性分析2018年1月1日~12月31日在西安市儿童医院和西安交通大学第一附属医院确诊为CKD的185例患儿的临床资料,其中发生CAL者37例,未发生CAL者148例;选取同时期93例上呼吸道病毒感染儿童为发热对照组,60例健康体检儿童为健康对照组。收集所有纳入对象的血细胞检测结果并进行统计学分析。结果CKD患儿中发生CAL者NLR和PLR均高于未发生CAL者,差异有统计学意义(χ2=3.69,4.13,均P<0.01);NLR和PLR预测川崎病CAL的cut-off值分别为4.13和126.82,敏感度和特异度分别为83.8%和76.1%(NLR)及81.1%和67.0%(PLR);NLR与PLR联合预测CAL的敏感度和特异度分别为86.5%和80.7%,ROC曲线下面积0.874。结论CKD急性期NLR与PLR对预测患儿是否发生CAL具有一定的价值。

Objective To explore the prediction value of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)for the development of coronary artery lesions(CAL)in children with complete Kawasaki disease(CKD).Methods 185 CKD patients who were hospitalized in Xi’an Children Hospital and the First Affiliated Hospital of Xi’an Jiaotong University from January 1,2018 to December 31,2018 were recruited in this study.Of these patients,37 individuals were with CAL and 148 were not with CAL.In addition,93 children with upper respiratory tract infection were enrolled as febrile controls and 60 children suffering healthy physical examination were as healthy controls.The blood routine results of all included subjects were collected for statistical analysis.Results The NLR and PLR values of CKD children suffering CAL were higher than those of CKD patients non-suffering CAL,the difference were statistically significant(χ2=3.69,4.13,all P<0.01).The cut-off values of NLR and PLR predicting KD-CAL were 4.13 and 126.82,respectively,resulting a 83.8%sensitivity and 76.1%specificity(NLR)and 81.1%sensitivity and 67.0%specificity(PLR).The prediction sensitivity and specificity of NLR combined with PLR were 86.5%and 80.7%,respectively,and the area under the ROC curve(AUC)was 0.874.Conclusion NLR combined with PLR has a good effect on predicting the development of CAL in CKD children.