ABSTRACT
<p><b>OBJECTIVE</b>To study the values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in predicting the sensitivity to intravenous immunoglobulin (IVIG) in Kawasaki disease (KD).</p><p><b>METHODS</b>A retrospective cohort study was conducted in 404 children with newly diagnosed KD. The data on routine blood tests, NLR, and PLR were collected before and after IVIG treatment. The receiver operating characteristic (ROC) curve was used to determine the cut-off values of NLR and PLR in predicting the insensitivity to IVIG. A logistic regression analysis was used to identify independent predictive factors for insensitivity to IVIG.</p><p><b>RESULTS</b>Of all patients, 31 were insensitive to IVIG. Compared with the IVIG sensitivity group, the IVIG insensitivity group had a significantly higher incidence rate of coronary artery ectasia (P<0.01), a shorter course of disease when IVIG therapy was initiated (P<0.05), and significantly higher NLR, PLR, and C-reactive protein (CRP) level before and after treatment (P<0.05). The optimal cut-off values for NLR and PLR to predict IVIG insensitivity were 4.36 and 162 before IVIG treatment and 1.45 and 196 after treatment. The multivariate regression analysis showed that the course of disease before IVIG treatment, CRP before IVIG treatment, and NLR and PLR before and after IVIG treatment were independent predictive factors for IVIG insensitivity.</p><p><b>CONCLUSIONS</b>NLR and PLR can be used to predict IVIG insensitivity in children with KD.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Blood Platelets , C-Reactive Protein , Immunoglobulins, Intravenous , Therapeutic Uses , Logistic Models , Lymphocytes , Mucocutaneous Lymph Node Syndrome , Blood , Drug Therapy , NeutrophilsABSTRACT
Objective To know the prevalence rate of iron deficiency anemia and its effect on growth and development among infants under 6 months. Methods A total of 341 infants who were born from July 2011 to June 2012 were enrolled. The information of blood routine examination,growth index,feeding patterns was collected at age of 42 days and 6 months,respectively. Developmental screening test was conducted at age of 6 months. Results The prevalence rate of anemia at 42 days was 37. 54%,and there was no significant difference between males(40. 54%)and females(33. 97%) (P>0. 05). The prevalence rate of iron deficiency anemia at 6 months was 19. 35%,in which 48. 48% were new cases. At age of 42 days,there was no significant difference between different feeding patterns in anemia prevalence( breast feeding:30. 82%,mixed feeding:41. 40%,artificial feeding:47. 37%,P>0. 05). While at age of 6 months,the anemia prevalence of breast feeding group was higher( 38. 20%)than that of the other two groups( mixed feeding:16. 38%;artificial feeding:9. 56%;P<0. 05 ). The rate of developmental quotient below 70 was 11. 76% in the anemia cases whose hemoglobin was continuously low from 42 days to 6 months,which was higher than that of new onset anemia cases (3. 13%)and normal hemoglobin controls(1. 82%)(P<0. 05). Conclusion Continuously low hemoglobin at early age of 42 days to 6 months is potentially harmful to neuropsychological development of infants. Early screening of hemoglobin is urgently needed for intervention of iron deficiency anemia among infants.