Pediatric Infectious Diseases, SBU Ankara Dr Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
Pediatric Infectious Diseases, Kayseri City Education and Research Hospital, Kocasinan, Turkey.
Klin Padiatr. 2022 Nov;234(6):382-387. doi: 10.1055/a-1816-6754. Epub 2022 Jul 4.
Kawasaki disease (KD) may cause cardiac and coronary complications. Since definite markers to accurately predict coronary involvement is not present, we aimed to analyze the role of hematological indices [neutrophil-to lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), lymphocyte-to monocyte ratio (LMR), and mean platelet volume (MPV)-to lymphocyte ratio (MPVLR)], prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) in predicting coronary involvement of KD. Patients The medical records of 134 KD patients admitted between January 2008 and December 2019 were investigated. Also, 268 age-matched healthy controls (HCs) were included in the study.
KD patients were divided into two groups: KD with coronary artery lesions (KD-CALs) and KD without CALs. Logistic regression analysis was performed to determine parameters that may predict coronary involvement in children with KD.
Among KD patients, 39 (29.1%) had CALs. When compared with HCs, the median levels of WBC, neutrophils, monocytes, eosinophils, platelets, MPV and, the values of NLR, PLR, MPVLR, SII were significantly higher; whereas lymphocyte count, PNI, platelet distribution width (PDW), LMR were markedly lower in the KD group (p˂0.001 for all, except for p=0.010 for eosinophil count). The CALs group's SII, PLR, and PNI values were significantly lower than those without (p=0.030, p=0.032, and p ˂0.001; respectively). Multivariable regression analysis revealed that PNI, SII, and gender (male) were associated with CALs in KD.
Our analysis revealed that male sex, lower PNI, and lower SII levels were independently associated with CALs in children with KD.
川崎病（KD）可导致心脏和冠状动脉并发症。由于目前尚无准确预测冠状动脉受累的明确标志物，我们旨在分析血液学指标[中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）和平均血小板体积与淋巴细胞比值（MPVLR）]、预后营养指数（PNI）和全身免疫炎症指数（SII）在预测 KD 冠状动脉受累中的作用。
我们调查了 2008 年 1 月至 2019 年 12 月期间收治的 134 例 KD 患者的病历。此外，还纳入了 268 名年龄匹配的健康对照者（HCs）。
KD 患者分为 KD 合并冠状动脉病变（KD-CALs）组和 KD 无 CALs 组。采用 logistic 回归分析确定可能预测 KD 患儿冠状动脉受累的参数。
在 KD 患者中，39 例（29.1%）存在 CALs。与 HCs 相比，KD 组的白细胞、中性粒细胞、单核细胞、嗜酸性粒细胞、血小板、MPV 中位数水平以及 NLR、PLR、MPVLR、SII 值显著升高；而淋巴细胞计数、PNI、血小板分布宽度（PDW）、LMR 明显降低（除嗜酸性粒细胞计数外，所有 P 值均＜0.001）。CALs 组的 SII、PLR 和 PNI 值明显低于无 CALs 组（p=0.030、p=0.032 和 p ＜0.001；分别）。多变量回归分析显示，PNI、SII 和性别（男）与 KD 中的 CALs 相关。
我们的分析表明，男性、较低的 PNI 和较低的 SII 水平与 KD 患儿的 CALs 独立相关。
