The Value Of Peripheral Blood Cell Ratio Of MPVLR,NLR And PLR In The Diagnosis Of Kawasaki Disease

Objective: To investigate the value of peripheral blood cell ratio,such as Mean platelet volume-to-lymphocyte ratio(MPVLR),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)in the diagnosis of kawasaki disease(KD),and its correlation of coronary artery lesions(CAL)and intravenous injection of human immunoglobulin(IVIG)sensitivity.Method: Retrospective study method was adopted,82 cases of children with KD are enrolled,according to the presence of CAL divided into CAL group(42 cases)and NCAL group(40 cases),according to the whether is sensitive to IVIG divided into IVIG-sensitive group(71 cases)and IVIG-resistant group(11 cases),and follow up the acute phase,subacute phase and recovery period of KD,and at the same time,select 83 cases of children with bronchopneumonia and normal physical examination in children with 84 cases as control group,the children with general information collection,and detection of three groups of complete routine blood c-reactive protein(CRP)and laboratory test results.IBM SPSS 20.0 data analysis software was used for data analysis.Results: 1.Non-parametric test indicated that the level of NLR in the acute phase was higher than that in the control group,and the level of PLR in the acute phase and subacute phase was higher than that in the control group(P<0.05).2.According to the ROC curve,MPVLR,NLR and PLR were included in the KD diagnosis system at the same time.The area,sensitivity and specificity under the curve of the combined diagnosis of acute phase and subacute phase were 0.89,79.3%,89.3% and 0.82,77.8%,85.7%,respectively(P<0.05).Combined with KD acute MPVLR,NLR and subacute PLR,the area,sensitivity and specificity under the curve were 0.945,86.1%and 86.9%.3.The MPVLR,NLR and PLR levels of CAL group were all higher than those of NCAL group significantly,and the NLR levels of IVIG insensitive groupwere higher than those of IVIG sensitive group significantly(P<0.05).4.Acute,subacute and recovery stages of MPVLR are all negatively correlated with the WBC(r = 0.23,0.75,0.74),the positive correlation between CRP and the acute phase(r =0.22),NLR in acute and subacute stage and the WBC(r = 0.48,0.28),the CRP positive correlation(r = 0.60,0.32),PLR and negatively correlated with the WBC in subacute,recovery(r = 0.53,0.49),and acute phase of CRP were positively correlated(r = 0.23),there are differences in data(P < 0.05).Conclusion: Peripheral blood cell ratio MPVLR,NLR and PLR are related to the onset of KD,which can be used as the predictors for early diagnosis of KD and judgment of CAL.Elevated NLR level is an insensitive predictor of IVIG.Low peripheral blood cell ratio may not indicate KD;In subacute,PLR may be more valuable in diagnosing KD.