Coşkun Serkan, Güngörer Vildan, Öner Nimet, Sezer Müge, Karagöl Cüneyt, Tekin Zahide Ekici, Tekgöz Pakize Nilüfer, Kaplan Melike Mehveş, Polat Merve Cansu, Çelikel Elif, Acar Banu Çelikel
Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
Pediatr Int. 2023 Jan-Dec;65(1):e15609. doi: 10.1111/ped.15609.
The aim of this study was to evaluate the role of the systemic immune inflammation index (SII), C-reactive protein/albumin ratio (CAR), the monocyte/lymphocyte ratio (MLR), and the neutrophil/lymphocyte ratio (NLR) in predicting disease severity, treatment, and prognosis in multisystem inflammatory syndrome in children (MIS-C).
This medical record review retrospectively evaluated the clinical and laboratory findings of 191 MIS-C patients followed in the Department of Pediatric Rheumatology at Ankara City Hospital, Turkey. The patients were grouped by disease severity: mild, moderate, and severe. SII, CAR, MLR, and NLR were calculated for each group.
All patients had fever at the time of admission; 153 (80.1%) had gastrointestinal tract involvement, 74 (38.7%) had rash, 63 (33%) had conjunctivitis, 107 (56%) had cardiac involvement, 32 (15.6%) had renal involvement, and 143 (74.9%) had hematological involvement. According to logistic regression analysis, SII, NLR, MLR, and CAR were found to be predictive indexes for disease severity, need for intensive care, need for inotropes, and anakinra treatment in MIS-C. The cut-off values of ≥1605.3 for SII, ≥9.1 for NLR, and ≥3.9 for CAR increased the risk of severe disease by 3.4, 7.1, and 5.7 times, respectively.
NLR, SII, MLR, and CAR are effective and useful for predicting the severity of MIS-C, the need for intensive care, and the need for anakinra treatment.
本研究旨在评估全身免疫炎症指数（SII）、C反应蛋白/白蛋白比值（CAR）、单核细胞/淋巴细胞比值（MLR）和中性粒细胞/淋巴细胞比值（NLR）在预测儿童多系统炎症综合征（MIS-C）的疾病严重程度、治疗及预后中的作用。
本病历回顾性研究评估了土耳其安卡拉市医院儿科风湿病科收治的191例MIS-C患者的临床和实验室检查结果。患者按疾病严重程度分组：轻度、中度和重度。计算每组的SII、CAR、MLR和NLR。
所有患者入院时均有发热；153例（80.1%）有胃肠道受累，74例（38.7%）有皮疹，63例（33%）有结膜炎，107例（56%）有心脏受累，32例（15.6%）有肾脏受累，143例（74.9%）有血液系统受累。根据逻辑回归分析，发现SII、NLR、MLR和CAR是MIS-C疾病严重程度、重症监护需求、血管活性药物需求和阿那白滞素治疗的预测指标。SII≥1605.3、NLR≥9.1和CAR≥3.9的临界值分别使重症疾病风险增加3.4倍、7.1倍和5.7倍。
NLR、SII、MLR和CAR在预测MIS-C的严重程度、重症监护需求和阿那白滞素治疗需求方面有效且有用。
