Clinical Significance Of Inflammatory Markers In The Diagnosis Of Kawasaki Disease In Children

Objective:to explore the clinical significance of peripheral blood lymphocyte/monocyte ratio(LMR),eosinophil/neutrophil ratio(ENR),platelet × neutrophil/lymphocyte ratio(PNLR),mean platelet volume/lymphocyte ratio(MPVLR)in the diagnosis of Kawasaki disease,so as to provide reference for early clinical diagnosis of Kawasaki disease.Methods:a total of 180 children with KD diagnosed in pediatrics in our hospital from December 2010 to December 2019 and 140 healthy children in the Child Healthcare Department of the same age were collected as the control group.The indexes of season,nationality,age,sex and the first blood routine after admission were recorded,and LMR,ENR,PNLR and MPVLR were calculated.The indexes between the two groups were compared and analyzed,and the normality of all data was tested and did not follow the normal distribution.The difference between the two groups of independent samples was tested by Mann-Whitney rank sum test,and the ROC curve was drawn and analyzed by SPSS statistical software.Results:1.There was no significant difference between male and female in KD group and control group,which was divided into age≤3 years group and age>3 years group according to age,and the proportion of age ≤3 years old group was higher than that of>3 years old group(P>0.05).2.Seasonal illness:24%in spring,30%in summer,21%in autumn and 25%in winter.The distribution among seasons was almost uniform,and there was no obvious seasonal incidence.3.Typical clinical manifestations of KD are:(1)bulbar conjunctival congestion(67%);(2)changes in mouth and mouth(64%);(3)cervical lymph node swelling(54%);(4)toe desquamation(38%);(5)pleomorphic rash(49%).There was no significant difference in typical clinical manifestations among different age groups(P>0.05).4.The levels of LMR and MPVLR in KD group were lower than those in control group,and the difference was statistically significant.(P<0.05),The level of ENR in the control group was significantly higher than that in the control group(P<0.05).There was no significant difference in PNLR level between the two groups(P>0.05).5.When LMR value is lower than the critical value of 4.45,MPVLR value is lower than the critical value of 1.60,and ENR value is higher than the critical value of 0.19,KD may be predicted.When compared with each other,the diagnostic(AUC 0.771)and sensitivity of LMR are the highest,but the specificity is the lowest,and the specificity of MPVLR is the highest,but the diagnostic and sensitivity are poor.6.Analysis of influencing factors of 6.KD:age,low LMR,low MPVLR,and high ENR may be related to the pathogenesis of KD.Conclusion:1.KD mostly occurs in children under 3 years old,and bulbar conjunctival congestion and changes of lip and mouth are the most common clinical manifestations of KD.2.If the LMR level is lower than 4.45 and the MPVLR level is lower than 1.60,it may be of predictive value to KD when the ENR level is higher than 0.19.Among them,the predictive value of lower LMR level for KD is higher than that of others.3.Multi variate analysis of Kawasaki disease showed that age was the protective factor,low LMR,low MPVLR and high ENR were risk factors.