Study on the Clinical Value of NLR,PLR,CAR Dynamic Monitoring in the Acute Phase of Kawasaki Disease
10.13241/j.cnki.pmb.2025.19.012
- VernacularTitle:NLR、PLR、CAR动态监测在川崎病急性期的临床价值研究
- Author:
Wei LI
1
;
Hui-ying LIAO
;
Mei-qing LI
;
Guo-hui TANG
Author Information
1. 广东医科大学附属第三医院(佛山市顺德区龙江医院)儿科 广东佛山 528318
- Publication Type:Journal Article
- Keywords:
NLR;
PLR;
CAR;
Dynamic monitoring;
Acute stage of Kawasaki disease
- From:
Progress in Modern Biomedicine
2025;25(19):3122-3130
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical value of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),C-reactive protein(CRP)to albumin(ALB)ratio(CAR)dynamic monitoring in the acute phase of Kawasaki disease(KD).Methods:This study was a single-center prospective study,146 in the acute phase of KD patients who were admitted to The Third Affiliated Hospital of Guangdong Medical University from June 2022 to September 2024 were selected as the study subjects(KD group).Hospitalized patients with fever ≥ 3 days received during the same period(fever control group,n=146)and healthy children underwent physical examination(healthy control group,n=146)were seleted.According to the differences in response to intravenous immunoglobulin treatment,KD patients were divided into two subgroups:immunoglobulin insensitive group(n=21)and immunoglobulin sensitive group(n=125).According to the presence or absence of coronary artery injury(CAL),KD patients were divided into two subgroups:non CAL group(n=97)and CAL group(n=49).According to alanine aminotransferase(ALT)expression level,KD patients were divided into two subgroups:non liver injury group(ALT value<80 U/L,n=110)and liver injury group(ALT value ≥ 80 U/L,n=36).NLR,PLR,and CAR of KD group,fever control group,and healthy control group were compared.NLR,PLR,and CAR were compared at admission,before and 3 d after immunoglobulin infusion between the immunoglobulin sensitive group and immunoglobulin insensitive group,liver injury group and non liver injury group,CAL group and non CAL group.Receiver operating characteristic(ROC)curve was used to evaluate diagnostic efficacy.Result:NLR,PLR,and CAR of the KD group and fever control group were higher than those of the healthy control group,and the KD group were higher than those of the fever control group(P<0.05).NLR,PLR,and CAR of the immunoglobulin insensitive group were higher than those of the immunoglobulin sensitive group at admission,before and 3 d after immunoglobulin infusion(P<0.05).NLR,PLR,and CAR of the liver injury group were higher than those of non liver injury group at admission,before and 3 d after immunoglobulin infusion(P<0.05).NLR,PLR,and CAR of the CAL group were higher than those of the non CAL group at admission,before and 3 days after immunoglobulin infusion(P<0.05).When NLR,PLR,and CAR were used alone or in combination at admission,the area under curve(AUC)(95%CI)of ROC values were 0.798(0.715~0.869),0.802(0.717~0.871),0.833(0.752~0.896),and 0.935(0.873~0.973),respectively,among them,the combination had the highest diagnostic efficacy.Conclusion:NLR,PLR,and CAR are all abnormally elevated in KD patients,and which are associated with patient immunoglobulin sensitivity,liver injury and CAL.The combination detection of the above three indicators has better diagnostic efficacy for KD.