Hong Seung Hee, Kim Chan Jong, Yang Eun Mi
Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea.
Pediatr Int. 2018 Sep;60(9):791-795. doi: 10.1111/ped.13652. Epub 2018 Sep 5.
Henoch-Schönlein purpura (HSP) is a common form of vasculitis in children. It typically involves small vessels of the skin, the gastrointestinal (GI) tract, joints, and kidneys. GI involvement is the most severe short-term complication and GI bleeding is a major complication of HSP, but there is no established predictive marker of GI bleeding. Blood neutrophil-to-lymphocyte ratio (NLR) has been proposed as a potentially useful marker of clinical outcome in diseases with an inflammatory component. The aim of this study was to clarify the association of NLR with HSP and investigate the usefulness of NLR as a marker to predict GI bleeding in children with HSP.
All patients with newly diagnosed HSP were reviewed retrospectively. White blood cell count, hemoglobin, platelet counts, mean platelet volume, neutrophil and lymphocyte count were evaluated. NLR and platelet-to-lymphocyte ratio (PLR) were calculated using complete blood count data.
This study involved 141 HSP patients. GI involvement was found in 65 patients (46.1%), and, of these, 15 (10.6%) had GI bleeding. At the time of diagnosis, NLR was significantly higher (P = 0.001) and PLR significantly lower (P = 0.032) in patients with GI bleeding than in those without GI bleeding. On logistic regression analysis, NLR was the only independent predictor of GI bleeding (P = 0.004). The optimal cut-off of NLR for predicting GI bleeding was 2.86 (sensitivity, 73%; specificity, 68%).
NLR, a simple and easily obtainable parameter, is a potential predictive marker of GI bleeding in children with HSP.
过敏性紫癜（HSP）是儿童常见的血管炎形式。它通常累及皮肤、胃肠道（GI）、关节和肾脏的小血管。胃肠道受累是最严重的短期并发症，胃肠道出血是HSP的主要并发症，但尚无公认的胃肠道出血预测指标。血液中性粒细胞与淋巴细胞比值（NLR）已被提出作为具有炎症成分疾病临床结局的潜在有用指标。本研究的目的是阐明NLR与HSP的关联，并探讨NLR作为预测HSP患儿胃肠道出血指标的有用性。
对所有新诊断的HSP患者进行回顾性研究。评估白细胞计数、血红蛋白、血小板计数、平均血小板体积、中性粒细胞和淋巴细胞计数。使用全血细胞计数数据计算NLR和血小板与淋巴细胞比值（PLR）。
本研究纳入141例HSP患者。65例（46.1%）患者出现胃肠道受累，其中15例（10.6%）发生胃肠道出血。在诊断时，胃肠道出血患者的NLR显著更高（P = 0.001），PLR显著更低（P = 0.032）。经逻辑回归分析，NLR是胃肠道出血的唯一独立预测因素（P = 0.004）。预测胃肠道出血的NLR最佳截断值为2.86（敏感性为73%；特异性为68%）。
NLR是一个简单且易于获得的参数，是HSP患儿胃肠道出血的潜在预测指标。
