标题：川崎病患儿NLR、PLR、SII、ESR水平变化及临床意义

      作者：刘武辉，林友青，骆晓文    海丰县澎湃纪念医院儿科，广东 海丰 516400

      卷次： 2021年32卷13期

      【摘要】 目的 观察川崎病患儿中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)、系统性免疫-炎症指数(SII)、红细胞沉降率(ESR)水平的变化并探讨其临床意义。方法 选择2018年1月至2020年10月海丰县澎湃纪念医院儿科收治的 56例川崎病患儿作为观察组，并选择同期于我院接受体检的正常儿童 50例作为对照组。观察组患儿均给予阿司匹林、丙种球蛋白常规治疗，持续治疗14 d。比较观察组和对照组，以及观察组合并与未合并冠脉损伤患儿的治疗前、治疗后14 d时的NLR、PLR、SII、ESR水平，采用Logistic回归分析法分析影响川崎病患儿发生冠脉损伤的危险因素。结果 治疗前，观察组患儿的 NLR、PLR、SII、ESR水平分别为(2.81±0.53)%、(128.84±14.52)%、(984.84±205.85)×109/L、(35.03±4.71) mm/h，明显高于对照组的(0.70±0.13)%、(65.05±8.30)%、(259.51±61.20)×109/L、(6.96±1.20) mm/h，差异均有统计学意义(P<0.05)；观察组患儿中10例合并冠脉损伤，发生率为17.86%；治疗前，合并冠脉损伤患儿的NLR、PLR、SII、ESR水平分别为(3.28±0.49)%、(171.04±26.19)%、(1 318.63±234.01)×109/L、(47.92±5.61) mm/h，明显高于未合并冠脉损伤患儿的 (2.57±0.33)%、(102.31±15.62)%、(715.04±177.28)×109/L、(26.05±4.81) mm/h，差异均有统计学意义(P<0.05)；治疗14 d后，合并冠脉损伤患儿NLR、PLR、SII、ESR水平分别为(1.85±0.30)%、(122.16±20.04)%、(991.02±182.41)×109/L、(22.51±3.03) mm/h，均明显高于未合并冠脉损伤患儿的(1.32±0.25)%、(79.45±15.83)%、(460.92±151.63)×109/L、(13.06±2.17) mm/h，差异均有统计学意义(P<0.05)；经Logistic回归分析结果显示，NLR、PLR、SII、ESR均是导致川崎病患儿发生冠脉损伤的独立危险因素(P<0.05)。结论 川崎病患儿NLR、PLR、SII、ESR水平明显升高，检测其水平有助于了解患儿的病情变化，临床应用价值高。
      【关键词】川崎病；冠脉扩张；中性粒细胞淋巴细胞比值；血小板淋巴细胞比值；系统性免疫-炎症指数；红细胞沉降率；临床意义
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2021）13—1698—04

Changes and clinical significance of NLR, PLR, SII and ESR in children with Kawasaki disease.
LIU Wu-hui, LINYou-qing, LUO Xiao-wen. Department of Pediatrics, Feipai Memorial Hospital, Haifeng 516400, Guangdong, CHINA
【Abstract】 Objective To observe the changes of neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio(PLR), systemic immune inflammatory index (SII) and erythrocyte sedimentation rate (ESR) in children with Kawasakidisease and to explore its clinical significance. Methods A total of 56 children with Kawasaki disease, who admitted toDepartment of Pediatrics, Feipai Memorial Hospital from January 2018 to October 2020, were selected as the observa-tion group, and 50 normal children who received physical examination in the same hospital during the same periodwere selected as the control group. The observation group was given aspirin, gamma globulin conventional treatment,continuously for 14 days. The expression of NLR, PLR, SII, and ESR levels in the observation group, control groupand observation group with and without coronary artery injury before and 14 days after treatment were compared. Lo-gistic regression analysis was used to analyze the risk factors of coronary artery injury in children with Kawasaki dis-ease. Results Before treatment, the NLR, PLR, SII, and ESR levels in the observation group were (2.81 ± 0.53)% ,(128.84 ± 14.52)% , (984.84 ± 205.85) × 109/L, (35.03 ± 4.71) mm/h, which were significantly higher than corresponding(0.70±0.13)%, (65.05±8.30)%, (259.51±61.20)×109/L, (6.96±1.20) mm/h of the control group (all P<0.05); there were10 children complicated with coronary artery injury in the observation group, with the incidence rate of 17.86%; beforetreatment, the NLR, PLR, SII and ESR levels in the children with coronary artery injury group were (3.28 ± 0.49)% ,(171.04±26.19)%, (1 318.63±234.01)×109/L, (47.92±5.61) mm/h, which were significantly higher than (2.57±0.33)%,(102.31±15.62)%, (715.04±177.28)×109/L, (26.05±4.81) mm/h of the children without coronary artery injury group (allP<0.05); after treatment for 14 d, the NLR, PLR, SII, and ESR levels in the children with coronary artery injury were(3.28±0.49)%, (171.04±26.19)%, (1 318.63±234.01)×109/L, (47.92±5.61) mm/h, which were significantly higher thancorresponding (1.32±0.25)%, (79.45±15.83)%, (460.92±151.63)×109/L, (13.06±2.17) mm/h of the children without coro-nary artery injury (all P<0.05); Logistic regression analysis showed that NLR, PLR, SII and ESR were independent riskfactors of coronary artery injury in children with Kawasaki disease (all P<0.05). Conclusion The expression of NLR,PLR, SII and ESR levels in children with Kawasaki disease are significantly increased, and the detection of their levelscan help to understand the changes of the disease in children, which is of