Abstract: 【Abstract】 Objective To investigate the diagnostic value of heart rate variability (HRV) and neutrophil-to-lymphocyte ratio (NLR) in children with Kawasaki disease with coronary artery lesions (CAL). Method From September 2017 to September 2019, 220 children with acute Kawasaki disease who were admitted to Kunming Children's Hospital were selected as the research objects, and 100 healthy children who came to the hospital for physical examination were server as the control group. The children were divided into CAL group (n=64) and non-CAL group (n=156) by the the results of echocardiography coronary examination. The levels of white blood cell (WBC), neutrophil count (NEU), lymphocyte count (LYM), and C-reactive protein (CRP) were detected, and NLR was calculated. HRV indicators were recorded by 24-hour Holter ECG: ① Time domain indicators: standard deviation in N-N Intervals (SDNN), SDNN index, 5 min N-N interval mean standard deviation(SDANN),root mean square of sussessive differences (rMSSD), percentage of N-N intervals over 50 ms different from preceding interval (PNN50). ② Frequency domain index: very low frequency(VLF, 0.003-0.040 Hz), low frequency (LF, 0.04-0.15 Hz), high frequency(HF, 0.15-0.40 Hz), the ratio of LF/HF. Statistical methods performed by One-way analysis of variance, independent samples t test, χ2 test, Logistic multivariate regression analysis, receiver operating characteristic curve (ROC) . Result The values of WBC in CAL group, non-CAL group and the control group were as follows: [(16.2±6.2)×109/L, (14.5±5.7)×109/L and (6.9±2.4)×109/L]. NEU were [(13.7±5.0)×109/L, (10.0±4.6)×109/L and (3.9±1.3)×109/L]. LYM were [(4.0±2.2)×109/L, (3.6±2.1)×109/L and (2.2±0.4)×109/L]. NLR were (4.5±5.1, 3.1±2.6, 1.6±1.1). CRP were [(37.7±6.8), (23.5±4.8) and (5.5±1.2) mg/L]. CAL group and non-CAL group were higher than those in the control group, CAL group were higher than those in the non-CAL group (all P<0.05). HRV time domain indicators SDNN in CAL group, non-CAL group and the control group were as follows: [(78±22), (93±37) and (97±36) ms]. SDANN were [(70±33), (79±30) and (83±34) ms]. SDNN index were [(45±20), (49±17) and (52±21) ms]. rMSSD were [(38±22), (41±30) and (50±22) ms], PNN50 were [(10±7)%, (13±10)% and (14±13)%]. Non-CAL group and the control group were higher than those in the CAL group, and the CAL group was lower than that in the non-CAL group (all P<0.05). HRV frequency domain indicators in CAL group, non-CAL group and the control group were as follows: VLF[(1011±443), (1246±597) and (1548±874) ms2], LF[(177±115), (294±167) and (544±238) ms2], HF[(111±93), (174±123) and (353±253)ms2], LF/HF[(2.4±1.3), (2.1±1.0) and (1.5±0.6) ]. The SDNN, SDANN, SDNN index, rMSSD, PNN50, VLF, LF, and HF of CAL group and non-CAL group were lower than those in the control group, and LF/HF were higher than those in the control group. The rMSSD, PNN50, VLF, LF, and HF were all lower than those in the non-CAL group, and LF/HF were higher than those in the non-CAL group (all P<0.05). Logistic multivariate regression analysis showed that WBC, NLR, CRP, SDNN, SDANN, VLF, LF/HF were independent influencing factors of CAL in cases with Kawasaki disease (OR values were 3.128, 3.128, 1.716,2.262, 2.843, 1.596, 5.262, P<0.05). ROC curve analysis showed that HRV and NLR had high diagnosticvalue for CAL in children with Kawasaki disease. Conclusion Combination of HRV and NLR can improve the predictive performance of CAL in children with Kawasaki disease, and has good clinical use.
杨燕飞 张丽萍. 心率变异性指标和中性粒细胞与淋巴细胞比值对小儿川崎病并发冠状动脉病变的诊断价值[J]. 发育医学电子杂志, 2022, 10(3): 174-181.
Yang Yanfei, Zhang Liping. Diagnostic value of heart rate variability indicators and neutrophil-to-lymphocyte ratio inchildren with Kawasaki disease with coronary artery lesions. Journal of Developmental Medicine(Electronic Version), 2022, 10(3): 174-181.
2022, Vol. 10 
