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Objective To assess the neutrophil-to-lymphocyte ratio (NLR) to predict coronary artery dilation in patients with Kawasaki disease (KD).Methods The blood routine were collected from all patients with KD before intravenous immunoglobulin(IVIG) treatment and after 2 days of IVIG treatment.NLR was calculated through dividing the neutrophil count by the lymphocyte.Multivariate Logistic analysis and receiver-operating characteristic (ROC) curve were used to determine the value of NLR predicting coronary artery dilation and the risk factors of coronary artery dilation in KD.Results Of the 404 cases with KD,50 cases were coronary artery dilation.Compared with the patients without coronary artery dilatation,patients with coronary artery dilatation were more inclined to occur in males (76.0％ vs.51.7％,x2 =10.45,P ＜0.01) at younger ages[(26.5 ±7.1) months vs.(31.3 ±8.4) months,t =3.85,P ＜ 0.01],while the days of fever pre-IVIG treatment [(6.9 ± 1.6) d vs.(5.5 ± 1.2) d,t =7.38,P ＜ 0.01] and after IVIG treatment [(4.7 ± 1.3) d vs.(2.1 ± 0.9) d,t =17.97,P ＜ 0.01] as well as total fever days [(10.2 ± 3.7) d vs.(7.5 ± 2.5) d,t =6.68,P ＜ 0.01] were all longer.Meanwhile,before IVIG treatment,patients with coronary artery dilatation had higher leukocytes [(18.6 ± 5.2) × 109/L vs.(15.4 ± 4.4) × 109/L,t =4.70,P ＜0.01],NLR value (4.5 ±0.8 vs.3.1 ± 0.4,t =19.82,P ＜0.01),neutrophil [(13.7 ±6.3) × 109/L vs.(10.2 ± 4.3) × 109/L,t =5.05,P＜0.01] and C-reactive protein(CRP) [(108.4 ±26.9) mg/Lvs.(99.5 ±32.3) mg/L,t =1.86,P ＜ 0.05],and the differences were statistically significant.However,between coronary artery dilatation group and non-coronary artery dilatation group,the lymphocyte number,platelet and erythrocyte sedimentation rate were not significantly different before IVIG treatment (all P ＞ 0.05).And the WBC [(10.4 ± 5.2) × 109/L vs.(8.3 ± 4.6) × 109/L,t=3.04,P＜0.01],NLR value (2.1 ±0.7 vs.1.2 ±0.5,t =13.87,P ＜0.01),nentrophil [(8.2 ± 1.7) × 109/L vs.(5.3 ± 1.2) × 109/L,t =16.37,P ＜0.01],platelet (PLT) [(492.4 ± 68.3) × 109/L vs.(445.6 ± 82.4) ×109/L,t=3.84,P＜0.01],CRP [(46.2±28.8) mg/L vs.(19.5±10.8) mg/L,t=12.47,P＜0.01],ESR[(45.9 ±28.6) mm/1 h vs.(28.2 ± 15.7) mm/1 h,t =6.63,P ＜0.01] of patients with coronary artery dilatation after IVIG treatment were also higher than the patients without coronary artery dilatation,and all of the differences were statistically significant.The ROC curve result revealed that the best NLR cut-off value during the acute febrile phase for predicting coronary artery dilation was 4.51,and the area under the curve was 0.82 (95％ CI 0.75-0.89) with sensitivity and specificity of 0.78 and 0.80,respectively.At the same time the best NLR cut-off values in 2 days after IVIG for predicting coronary artery dilation was 1.46,and the area under the curve was 0.85 (95％ CI 0.79-0.92) with sensitivity and specificity of 0.84 and 0.79,respectively.Multivariate Logistic analysis revealed that the days of fever before and after IVIG treatment,total fever days,NLR before and after IVIG treatment,as well as WBC and CRP after treatment with IVIG were all independent predictive factors of coronary artery dilation development.Conclusion The NLR could be used to predict coronary artery dilation development in patients with KD.
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Objective To investigate the relationship between inflammatory factors, coronary artery dilation, and their clinical significance. Methods The cases undergone coronary angiography in our hospital last year were collected and divided into three groups: the first one included 11 patients whose angiography showed coronary artery dilation, the second group included 35 cases of atherosclerosis, and the third includes 24 cases with normal angiography. sES, MMP9 and TIMP1 were measured by ELISA method. Results Patients with coronary artery dilation were found to have significantly higher sES and MMP-9 level in comparison with atherosclerosis group and normal group[(153.7?152.7)ng/L,(90.1?54.2)ng/L,(76.5?37.2)ng/L, respectively](P