Clinical Predictive Value Of LMR And NLR In Children With Renal Injury Of Henoch-Schonlein Purpura

Objective:To investigate the clinical predictive value of lymphocyte to monocyte ratio(LMR)and neutrophil to lymphocyte ratio(NLR)in children with Henoch-Schonlein purpurain to the diagnosis of renal injury.Methods:From January 2012 to December 2017,195 patients with HSP were hospitalized in Yanbian University hospital,and divided according to whether there wasrenal injury or not,clinical features were analyzed.120 healthy children of the same age in the same period were used as controls.At admission,the blood routine neutrophil counts(NEU),lymphocyte counts(LYM),and monocyte counts(MON)were measured,and the values of LMR and NLR were calculated.The predictive value of LMR and NLR in renal injury in children with HSP was analyzed by ROC curve.Results:1.The average age of 195 children with HSP was 6.8±2.4 years,and 124 cases(64%)were between 2-8 years of age.The ratio of men and women was 1:1.14.The average length of hospital stay was 6.012.3 days,and the incidence was highest in spring;There was a history of acute infection between 1 and 3 weeks before onset the disease in 80 cases(41%),including 67 cases(34.4%)of upper respiratory tract infections.2.There was no significant difference in gender,nationality and days of hospitalization between the renal and non-renal injury groups.The average age of the renal damage group(7.9±2.6 years)was higher than the non-renal group(6.6±2.4 years)(P<0.05),the difference was statistically significant.3.NEU and NLR in HSP group were higher than those in control group(P<0.05).LYM and LMR were lower than those in control group(P<0.05),the difference was statistically significant,there was no significant difference in MON(P>0.05)between the two groups.4.NEU,MON,and NLR in the renal injury group was significantly higher than that in the non-renal injury group(P<0.05),LMR was lower in the renal injury group than in the non-renal injury group(P<0.05),there was no difference between the two groups in LYM(P>0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of LMR was 0.701,when the cutoff value was 4.925,the sensitivity was 63.6%and the specificity was 80%;The AUC of the NLR was 0.653,when the Cutoff value was 2.247,the sensitivity was 69.1%,the specificity was 60.0%;The AUC of MON was 0.63,when the Cutoff value was 0.595,the specificity was 70.0%,and the sensitivity was 58.8%;The AUC of NEU was 0.617,when the Cutoff was 7.365,the sensitivity was 77.60%and the specificity was 43.3%.Conclusion:1.Age may be a risk factor for renal injury in children with HSP,the old er the children.were,the more likely the kidneys are involved.2.Combined with clinical manifestations,LMR,NLR have a certain predictive value for the clinical diagnosis of HSP renal injury,both of which are more predictive than single indicators of NEU and MON.