Ahmed Mai, El Amrousy Doaa, Hodeib Hossam, Elnemr Shimaa
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Cardiol Young. 2023 Dec;33(12):2493-2497. doi: 10.1017/S1047951123000501. Epub 2023 Mar 17.
We aimed to evaluate neutrophil-to-lymphocyte ratio in children with acute heart failure due to dilated cardiomyopathy, to assess the predictive and prognostic values of neutrophil-to-lymphocyte ratio, and to correlate its levels with brain natriuretic peptide and other various data in these patients.
We included 50 children with acute heart failure due to dilated cardiomyopathy as the patient group. Fifty healthy children of matched age and sex served as the control group. Patients were evaluated clinically and by echocardiography. A complete blood count with differentiation to evaluate neutrophil-to-lymphocyte ratio was done, and the serum level of brain natriuretic peptide was also measured. All patients were followed up for death or readmission for a period of one year.
Neutrophil-to-lymphocyte ratio was significantly higher in patient group as compared to the control group. Neutrophil-to-lymphocyte ratio was significantly increased in patients with higher severity of heart failure. There was a significant increase in neutrophil-to-lymphocyte ratio in patients with bad prognoses compared to those with good prognoses. There was a significant positive correlation between neutrophil-to-lymphocyte ratio and both brain natriuretic peptide and clinical stage of heart failure while there was a significant negative correlation between neutrophil-to-lymphocyte ratio and left ventricular systolic function. The best cut-off of neutrophil-to-lymphocyte ratio to predict adverse outcomes in children with dilated cardiomyopathy was >3.6 with 87% sensitivity and 79% specificity. The cut-off of neutrophil-to-lymphocyte ratio to predict patients who will not respond to conventional treatment was ≥3.85 with 85% sensitivity and 100% specificity.
Neutrophil-to-lymphocyte ratio is a cheap good predictive and prognostic biomarker in children with dilated cardiomyopathy.
我们旨在评估扩张型心肌病所致急性心力衰竭患儿的中性粒细胞与淋巴细胞比值，评估中性粒细胞与淋巴细胞比值的预测和预后价值，并将其水平与这些患者的脑钠肽及其他各项数据进行关联。
我们纳入50例扩张型心肌病所致急性心力衰竭患儿作为患者组。50例年龄和性别匹配的健康儿童作为对照组。对患者进行临床评估及超声心动图检查。进行全血细胞计数及分类以评估中性粒细胞与淋巴细胞比值，并检测血清脑钠肽水平。所有患者随访一年，观察死亡或再次入院情况。
与对照组相比，患者组中性粒细胞与淋巴细胞比值显著更高。心力衰竭严重程度较高的患者中性粒细胞与淋巴细胞比值显著升高。预后不良的患者与预后良好的患者相比，中性粒细胞与淋巴细胞比值显著升高。中性粒细胞与淋巴细胞比值与脑钠肽及心力衰竭临床分期均呈显著正相关，而与左心室收缩功能呈显著负相关。预测扩张型心肌病患儿不良结局的中性粒细胞与淋巴细胞比值最佳截断值>3.6，敏感性为87%，特异性为79%。预测对常规治疗无反应患者的中性粒细胞与淋巴细胞比值截断值≥3.85，敏感性为85%，特异性为100%。
中性粒细胞与淋巴细胞比值是扩张型心肌病患儿一种廉价且良好的预测和预后生物标志物。
