The Prediction Significance Of Peripheral Blood Cell Parameters For Coronary Artery Lesion In Children With Complete Kawasaki Disease In Different Age-groups

Objective: To retrospectively analyze the clinical data of 1019 children with complete Kawasaki disease(c KD),analyzed and summarized the characteristics of the disease,and discussed the predictive significance of peripheral blood parameters for Coronary artery injury(CAL),and to provide the scientific basis for clinical diagnosis and treatment.Methods: Retrospective study method was adopted,collect the clinical data of1019 children who were diagnosed as complete Kawasaki disease first time in our hospital between January 2017 and October 2021,according to ages divided into <1year group,1~3 years old group,3~5 years old group and ≥5 years old group,and then the four groups were divided into complete Kawasaki disease with coronary artery lesions(c KD-CAL)and complete Kawasaki disease with non-coronary artery lesions(c KD-non CAL)according to whether it has CAL.SPSS 26.0 data analysis software was used for data analysis of epidemiological characteristics,general data and auxiliary examination data of total cases.Results: 1.Clinical data:(1)a total of 1019 children with c KD were included,the minimum age was 1 month 6 days and the maximum age was 138 months 24 days,with a wide age range months,the sex ratio of male to female was 1.65.The proportions of Han and ethnic minorities were 71.93%(733/1019)and 28.07%(286/1019),respectively.The incidence rate was increasing year by year.c KD occurred more frequently in spring and summer,with June as the peak month and November as the trough month,CAL occurred in 358(35.13%)patients,including37(3.63%)with medium aneurysms,No giant coronary aneurysm and death were found in this survey.2.Laboratory results:(1)total cases without age division:(1)c KD-CAL group had higher AST,ALT,CRP,ESR and WBC than those in c KD-non CAL,while the blood sodium and lymphocyte were lower than those in CKD-non CAL group,and the difference were statistically significant(P <0.05).(2)c KD-CAL group had higher NLR、PLR、MPVLR than those in c KD-non CAL group,and the difference were statistically significant(P <0.05).(2)Grouped by age:(1)patients < 1 year old and 1~3 years old with c KD-CAL had higher NLR、PLR、MPVLR than those in patients with c KD-non CAL,and the difference were statistically significant(P <0.05).(2)NLR,PLR and MPVLR among 3~ 5 years old patients with CKD-CAL were higher than those in patients with c KD-non CAL,and there were no significant difference between the two groups(P >0.05).(3)NLR,PLR and MPVLR in ≥5 years old patients c KD-CAL group were lower than those of CKD-non CAL group,and there was no statistical significance(P >0.05).3.The results of ROC curve for predicting CAL:(1)total cases without age division:(1)the area under the ROC curve of NLR、PLR、MPVLR for predicting CAL were 0.594,0.581 and 0.556 respectively,the sensitivity under the cure were 66.9%、65.7% and66.1% respectively,and the specificity was 48%,50.8% and 46.4%(P <0.05).(2)The area,sensitivity and specificity under the ROC curve of c KD-CAL predicted by NLR combined with PLR was 0.592,78.2% and 36.6%,respectively(P <0.05).(2)Grouped by age:1)patients <1 year old group:(1)The area under ROC curve of NLR、PLR、MPVLR for predicting CAL were 0.691,0.659 and 0.647 respectively,the sensitivity of cure was 74.5%,87.6% and 75.9% respectively,and the specificity was 58%,39.1% and 56.5%,respectively(P<0.05).(2)The area,sensitivity and specificity under the ROC curve of c KD-CAL predicted by NLR combined with PLR was 0.688,74.8% and 57.5%,respectively(P <0.05).2)1 ~ 3 years old group:(1)The area under ROC curve of NLR、PLR、MPVLR for predicting CAL were 0.638,0.616 and 0.606 respectively,the sensitivity under the cure was 76%,75.3% and78.9% respectively,and the specificity was 46.6%,47.1% and 42.9%,respectively(P<0.05).(2)The area,sensitivity and specificity under the ROC curve of c KD-CAL predicted by NLR combined with PLR was 0.627,85.4% and 37.6%,respectively(P<0.05).Conclusion:(1)High NLR 、 PLR 、 MPVLR before initial IVIG had certain predictive significance for CAL in patients with c KD under 3-year old。(2)The combination of high NLR and PLR was a stronger predicator than either alone in patients with c KD among 1~3-year old,but the predictive efficacy of the combined NLR and PLR for CAL in patients with c KD within 1-year old was not improved.(3)Age is a factor affecting the predictive value of NLR,PLR,MPVLR and NLR combined with PLR for CAL in children with c KD.