Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (3): 174-181 DOI: 10.3969/j.issn.2095-5340.2022.03.003 |
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| Diagnostic value of heart rate variability indicators and neutrophil-to-lymphocyte ratio inchildren with Kawasaki disease with coronary artery lesions |
| Yang Yanfei, Zhang Liping
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1. Special Ward, Kunming Children's Hospital, Yunnan, Kunming 650034,China; 2. Department of Cardiovascular Medicine, Kunming Children's Hospital, Yunnan, Kunming 650034,China
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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.
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Received: 24 February 2021
Published: 30 May 2022
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