The value of serum ferritin combined with neutrophil-to-lymphocyte ratio in predicting IVIG resistance in Kawasaki disease
10.3760/cma.j.cn101721-20241009-00317
- VernacularTitle:SF联合NLR预测川崎病患儿IVIG抵抗的价值
- Author:
Ting ZHANG
1
;
Jie WU
;
Xin LI
Author Information
1. 云南省昆明市儿童医院呼吸内科，昆明 650228
- Publication Type:Journal Article
- Keywords:
Kawasaki disease;
Neutrophil-to-lymphocyte ratio;
Serum ferritin;
Intravenous immunoglobulin;
Children
- From:
Clinical Medicine of China
2025;41(5):333-339
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of serum ferritin (SF) and neutrophil-to-lymphocyte ratio (NLR) in predicting intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD).Methods:Clinical data from 193 KD children hospitalized at Kunming Children's Hospital (January 2018 - December 2023) were retrospectively analyzed. Patients were stratified into IVIG-sensitive ( n=159) and IVIG-resistant ( n=34) groups. Demographic characteristics and laboratory parameters (SF, NLR, etc.) were compared. Normally distributed continuous variables were expressed as xˉ± s and analyzed by independent samples t-test; non-normally distributed data were expressed as M ( Q1, Q3) and compared by Mann-Whitney U tests. Categorical data were expressed as case(%) and compared by χ2 tests. Pearson's analysis was used on correlation analysis, logistic regression was used on multivariate analysis. Predictive accuracy was evaluated by receiver operating characteristic (ROC) curves. Results:SF [(429.56±307.74) μg/L], NLR (7.52±4.80), WBC [(19.66±9.02) × 10 9/L], NEUT [(15.41±6.81) × 10 9/L], AST [46.00 (23.00, 130.25) U/L], ALT [113.50 (36.50, 205.00) U/L], CRP [(123.66±59.38) mg/L] and ESR [(76.47±25.97) mm/h] were higher in the IVIG resistant group than the IVIG sensitivity group [(213.89±127.98) μg/L, 3.88±3.71, (14.58±5.15) × 10 9/L, (9.76±4.64) × 10 9/L, 27.00 (22.00, 40.00) U/L, 40.00 (17.00, 95.00) U/L, (81.40±55.65) mg/L, (65.40±23.05) mm/h]. LYMP [(2.77±1.97) × 10 9/L] and albumin [(29.10±4.96) g/L] were lower in the IVIG resistant group than the IVIG sensitivity group [(3.66±1.86) × 10 9/L, (32.52±4.04) g/L], and the differences were statistically significant (statistical values were t=4.01, t=4.17, t=3.17, t=4.61, Z=2.74, Z=3.39, t=3.97, t=2.48, t=2.51, t=4.30, respectively, P values were 0.001, 0.001, 0.001, 0.001, 0.006, 0.001, 0.001, 0.014, 0.013, 0.001). Logistic regression analysis showed that serum ferritin ( OR=1.004, 95% CI: 1.001-1.006) and NLR ( OR=1.108, 95% CI: 1.007-1.218) were risk factors for IVIG resistance (P values were 0.035 and 0.002, respectively). The area under ROC curve for predicting IVIG resistance using serum ferritin combined with NLR was 0.812, with sensitivity and specificity of 76.47% and 72.96%, respectively. Conclusion:High levels of SF and NLR are independent risk factors for predicting IVIG resistance. SF combined with NLR has a certain predictive value for IVIG resistance in Kawasaki disease.
