Changes And Clinical Significance Of Peripheral Blood Cell Ratios Of NLR、PLR And SII In Children With Kawasaki Disease

ObjectiveTo observe the changes of neutrophil-to-lymphocyte ratio（NLR）,platelet-to-lymphocyte ratio（PLR）and systemic immune-inflammation index（SII）in children with Kawasaki disease（KD）,and to explore its reference value for early diagnosis and prediction of CAD in KD.MethodsBy retrospective study,60 children with kawasaki disease at acute stage who were first diagnosed in our hospital from September 2019 to October 2021 were included in KD disease group.The Kawasaki group was divided into CAD group and NCAD group according to whether there was coronary dilatation or not.60 normal children who received physical examination in our hospital during the same period were enrolled as the healthy control group,and another 60 children diagnosed as mild acute bronchopneumonia were enrolled as the pneumonia control group.Routine blood results of healthy group,Kawasaki group and pneumonia group before treatment were collected,including neutrophil count,lymphocyte count and platelet count,and NLR,PLR and SII values were calculated.IBM SPSS 26.0 statistical software was used for data analysis.Results1.The level of NLR in Kawasaki disease group [3.47（2.50,5.09）] was significantly higher than that in pneumonia group [1.44（0.82,2.23）] and healthy control group[0.55（0.35,0.83）],（P<0.05）.The level of NLR in the pneumonia group was significantly higher than that in the healthy group（P<0.05）.2.The level of PLR in Kawasaki disease group [99.16（74.94,130.32）] was significantly higher than that of pneumonia group [78.00（59.10,105.80）] and healthy group [72.58（59.10,82.7）],（P<0.05）。There was no significant difference in PLR level between pneumonia group and healthy group（P>0.05）.3.The level of SII in Kawasaki disease group [989.12（790.37,1369.11）] was significantly higher than that in pneumonia group [343.05（199.11,549.12）] and healthy group [179.86（101.27,210.95）],（P<0.05）.Meanwhile,the level of SII in pneumonia group was significantly higher than that in healthy group（P<0.05）.4.NLR,PLR and SII in Kawasaki disease group with coronary artery dilatation were higher than those in group without coronary artery dilatation（P<0.05）.5.ROC curve was used to analyze the predictive ability of NLR,PLR and SII for CAD in Kawasaki disease.The area under curve（AUC）corresponding to NLR value,PLR value and SII value were 0.812,0.770 and 0.877,respectively.The optimal cut-off points corresponding to each index were 5.350,110.629 and 1566.435,respectively.The corresponding sensitivity was 0.600,0.733 and 0.667,respectively.The corresponding specificity were 0.889,0.756 and 0.978,respectively.6.Binary logistics was used to analyze whether each clinical indicator was an independent risk factor for KD combined with CAD.The results of binary Logistic regression analysis showed that SII was independent risk factors for coronary artery dilatation in children with Kawasaki disease.Conclusions1.The levels of peripheral blood cell ratio NLR,PLR and SII in children with Kawasaki disease increased significantly in the acute stage,which has reference value for the early diagnosis of Kawasaki disease.2.Peripheral blood cell ratio NLR,PLR and SII have a predictive value for children with KD complicated with CAD.The predictive value of SII may be higher than NLR and PLR.