Lee Jeong Won, Park Joon Soo, Park Kyeong Bae, Yoo Gyeong Hee, Kim Seung Soo, Lee Sang Mi
Sang Mi Lee, M.D., Ph.D., Soonchunhyang University Cheonan Hospital,, 23-20 Byeongmyeong-dong,, Dongnam-gu, Cheonan,, Chungcheongnam-do, 330-721, Korea, Tel: +82-41-570-3540, Fax: +82-41-572-4655, E-mail:
Nuklearmedizin. 2017 Jun 12;56(3):109-114. doi: 10.3413/Nukmed-0878-17-01. Epub 2017 May 10.
This study is aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for cortical defect on initial and follow-up Tc-99m dimercaptosuccinic acid (DMSA) scan in children with the first febrile urinary tract infection (UTI).
We retrospectively enrolled 179 children with the first febrile UTI who underwent DMSA scan and laboratory tests. In patients with abnormal DMSA scan findings, follow-up DMSA scan was performed at least 6 months after the initial scan. All DMSA scans were classified as negative and positive cortical defects. Multiple logistic regression analyses were performed to identify the risk factors for cortical defect on initial and follow-up DMSA scan.
Cortical defects on initial DMSA scan were noted in 133 patients. Vesicoureteral reflux (VUR), white blood cell count, absolute neutrophil count, NLR, and serum C-reactive protein level were independent predictive factors for positive cortical defect on initial DMSA scan (p < 0.050). On follow-up DMSA scan, 24 of the 133 patients showed persistent cortical defects, and only VUR was significantly associated with persistent cortical defect (p = 0.002). In 84 patients who showed cortical defect on initial scan and absence of VUR, only NLR was significantly associated with persistent cortical defect on follow-up scan (p = 0.025).
NLR was significantly associated with persistent cortical defect on follow-up DMSA scan in patients without VUR, as well as positive cortical defect on initial scan.
本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）对首次发热性尿路感染（UTI）患儿初始及随访99m锝二巯基丁二酸（DMSA）扫描时皮质缺损的预测价值。
我们回顾性纳入了179例接受DMSA扫描和实验室检查的首次发热性UTI患儿。对于DMSA扫描结果异常的患者，在初始扫描后至少6个月进行随访DMSA扫描。所有DMSA扫描分为阴性和阳性皮质缺损。进行多因素逻辑回归分析以确定初始及随访DMSA扫描时皮质缺损的危险因素。
133例患者在初始DMSA扫描时发现皮质缺损。膀胱输尿管反流（VUR）、白细胞计数、绝对中性粒细胞计数、NLR和血清C反应蛋白水平是初始DMSA扫描时阳性皮质缺损的独立预测因素（p < 0.050）。在随访DMSA扫描中，133例患者中有24例显示持续性皮质缺损，只有VUR与持续性皮质缺损显著相关（p = 0.002）。在84例初始扫描时显示皮质缺损且无VUR的患者中，只有NLR与随访扫描时的持续性皮质缺损显著相关（p = 0.025）。
在无VUR的患者中，NLR与随访DMSA扫描时的持续性皮质缺损以及初始扫描时的阳性皮质缺损显著相关。
