NLR与MLR联合诊断川崎病合并肝损伤的价值

The value of neutrophil-to-lymphocyte ratio combined with monocyte-to-lymphocyte ratio in diagnosis of Kawasaki disease complicated with liver injury

目的探讨中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)和单核细胞与淋巴细胞比值(monocyte-to-lymphocyte ratio,MLR)联合诊断川崎病合并肝损伤的价值。方法收集208例川崎病患儿的一般资料和血细胞参数等,根据是否发生肝损伤,将其分为川崎病无肝损伤组(115例)和川崎病合并肝损伤组(93例)。通过二元logistic回归分析及绘制受试者工作特征(receiver operating characteristic,ROC)曲线,探究NLR、MLR及2者联合对川崎病合并肝损伤的诊断价值。结果川崎病患儿208例,其中合并肝损伤有93例,发生率为44.71%。与川崎病无肝损伤组比较,川崎病合并肝损伤组患儿白细胞数量、NLR和MLR等显著性变化,2组间差异均有统计学意义(P<0.05)。二元logistic回归分析结果显示,NLR和MLR是川崎病患儿合并肝损伤的独立危险因素(P<0.05)。NLR、MLR及二者联合诊断川崎病合并肝损伤的ROC曲线下面积分别为0.812、0.668、0.824。结论NLR和MLR可用于诊断川崎病合并肝损伤,且NLR的诊断价值优于MLR,联合检测效果更好。

Objective This paper aims to investigate the combined value of neutrophil-to-lymphocyte ratio(NLR)and monocyte-to-lymphocyte ratio(MLR)in the diagnosis of Kawasaki disease with liver injury.Methods The general data and blood cell parameters of 208 children with Kawasaki disease were collected.According to the occurrence of liver injury,they were divided into Kawasaki disease without liver injury group(115 cases)and Kawasaki disease with liver injury group(93 cases).By binary logistic regression analysis and receiver operating characteristic(ROC)curve,the diagnostic values of single NLR and MLR and their combination in Kawasaki disease complicated with liver injury was explored.Results Among 208 children with Kawasaki disease,93 cases were complicated with liver injury,with an incidence of 44.71%.Compared with Kawasaki disease without liver injury group,leukocyte count,NLR and MLR of Kawasaki disease combined with liver injury group were significantly changed,and the differences were statistically significant(P<0.05).Binary logistic regression analysis showed that NLR and MLR were independent risk factors for liver injury in children with Kawasaki disease(P<0.05).The area under ROC curve of single NLR and MLR and their combination in the diagnosis of Kawasaki disease complicated with liver injury were 0.812,0.668 and 0.824,respectively.Conclusion NLR and MLR can be used to diagnose Kawasaki disease complicated with liver injury,and the diagnostic value of NLR is better than MLR,and the efficacy of combined detection is better.