Abstract：
BACKGROUND: Kawasaki disease is a vasculitis that can lead to cardiac complications, including coronary artery disease and cardiogenic shock. Various scoring systems have been developed to determine those that will be refractory to routine intravenous immunoglobulin therapy or develop coronary artery disease. The objective of this study was to determine if the neutrophil-lymphocyte ratio could predict refractory disease and coronary artery lesions in patients with Kawasaki disease.
METHODS: A systematic review of the literature was performed to identify manuscripts describing comparisons of neutrophil-lymphocyte ratio between those who had refractory disease and those who did not, and between those who developed coronary artery lesions and those who did not. Mean difference was compared between groups. Areas under the curve were utilised to determine the pooled area under the curve.
RESULTS: 12 studies with 5593 patients were included in the final analyses of neutrophil-lymphocyte ratio for the prediction of refractory disease. Neutrophil-lymphocyte ratio before therapy was higher in refractory disease with a mean difference of 2.55 (p < 0.01) and pooled area under the curve of 0.724. Neutrophil-lymphocyte ratio after therapy was higher in refractory disease with a mean difference of 1.42 (p < 0.01) and pooled area under the curve for of 0.803. Five studies with 1690 patients were included in the final analyses of neutrophil-lymphocyte ratio for the prediction of coronary artery lesions. Neutrophil-lymphocyte ratio before therapy was higher in coronary artery lesions with a mean difference of 0.65 (p < 0.01).
CONCLUSIONS: The use of neutrophil-lymphocyte ratio may help physicians in the identification of patients at risk of refractory disease and coronary artery lesions in patients with Kawasaki disease.
METHODS: A systematic review of the literature was performed to identify manuscripts describing comparisons of neutrophil-lymphocyte ratio between those who had refractory disease and those who did not, and between those who developed coronary artery lesions and those who did not. Mean difference was compared between groups. Areas under the curve were utilised to determine the pooled area under the curve.
RESULTS: 12 studies with 5593 patients were included in the final analyses of neutrophil-lymphocyte ratio for the prediction of refractory disease. Neutrophil-lymphocyte ratio before therapy was higher in refractory disease with a mean difference of 2.55 (p < 0.01) and pooled area under the curve of 0.724. Neutrophil-lymphocyte ratio after therapy was higher in refractory disease with a mean difference of 1.42 (p < 0.01) and pooled area under the curve for of 0.803. Five studies with 1690 patients were included in the final analyses of neutrophil-lymphocyte ratio for the prediction of coronary artery lesions. Neutrophil-lymphocyte ratio before therapy was higher in coronary artery lesions with a mean difference of 0.65 (p < 0.01).
CONCLUSIONS: The use of neutrophil-lymphocyte ratio may help physicians in the identification of patients at risk of refractory disease and coronary artery lesions in patients with Kawasaki disease.
摘要：
背景：川崎病是一种血管炎，可导致心脏并发症，包括冠状动脉疾病和心源性休克。已经开发了各种评分系统来确定常规静脉内免疫球蛋白治疗难以治疗或发展为冠状动脉疾病的评分系统。这项研究的目的是确定中性粒细胞-淋巴细胞比率是否可以预测川崎病患者的难治性疾病和冠状动脉病变。
方法：对文献进行了系统综述，以确定描述难治性疾病患者和非难治性疾病患者中性粒细胞-淋巴细胞比率比较的手稿，在发生冠状动脉病变的人和没有发生冠状动脉病变的人之间。比较各组之间的平均差异。利用曲线下的面积来确定曲线下的汇集面积。
结果：12项包含5593名患者的研究被纳入中性粒细胞-淋巴细胞比率的最终分析，用于预测难治性疾病。难治性疾病治疗前中性粒细胞-淋巴细胞比率较高，平均差异为2.55（p<0.01），曲线下的合并面积为0.724。难治性疾病治疗后中性粒细胞-淋巴细胞比率较高，平均差异为1.42（p<0.01），曲线下的合并面积为0.803。对1690例患者的5项研究被纳入中性粒细胞-淋巴细胞比率的最终分析，以预测冠状动脉病变。冠状动脉病变治疗前中性粒细胞-淋巴细胞比值较高，平均差异为0.65（p<0.01）。
结论：使用中性粒细胞-淋巴细胞比率可能有助于医生识别川崎病患者中存在难治性疾病和冠状动脉病变风险的患者。
方法：对文献进行了系统综述，以确定描述难治性疾病患者和非难治性疾病患者中性粒细胞-淋巴细胞比率比较的手稿，在发生冠状动脉病变的人和没有发生冠状动脉病变的人之间。比较各组之间的平均差异。利用曲线下的面积来确定曲线下的汇集面积。
结果：12项包含5593名患者的研究被纳入中性粒细胞-淋巴细胞比率的最终分析，用于预测难治性疾病。难治性疾病治疗前中性粒细胞-淋巴细胞比率较高，平均差异为2.55（p<0.01），曲线下的合并面积为0.724。难治性疾病治疗后中性粒细胞-淋巴细胞比率较高，平均差异为1.42（p<0.01），曲线下的合并面积为0.803。对1690例患者的5项研究被纳入中性粒细胞-淋巴细胞比率的最终分析，以预测冠状动脉病变。冠状动脉病变治疗前中性粒细胞-淋巴细胞比值较高，平均差异为0.65（p<0.01）。
结论：使用中性粒细胞-淋巴细胞比率可能有助于医生识别川崎病患者中存在难治性疾病和冠状动脉病变风险的患者。
