Abstract

Objectives

This study aimed to investigate the influence of neutrophil-to-lymphocyte ratio (NLR) on the severity and short-time curative effect of myasthenia gravis (MG) in children.

Methods

Data of 132 MG children were retrospectively analyzed, and data of 140 healthy controls (HC group) in the same period were collected. The data of both groups were compared and analyzed.

Results

NLR of MG group was significantly higher than that of HC group (Z = 2.644, p = 0.008). According to NLR level, patients were divided into 3 groups: N1 (NLR < 1.03), N2 (NLR 1.03-2.17), and N3 (NLR > 2.17). Significant differences in white blood cell counts, course of disease, uric acid, albumin and the time of hospital stay among the 3 groups were observed (p < 0.05, 0.01). The results of logistic regression revealed that NLR (adjusted OR = 3.874, 95% CI 1.359-11.045, p = 0.011) was the risk factor of MG, and it was risk factor of higher QMG during admission (adjusted OR = 2.989, 95% CI 1.247-7.160, p = 0.014) as well. Using the NLR level for the MG diagnostic test, the area under the receiver operating characteristic (ROC) curve was 0.765 [95%CI (0.710-0.820), p = 0.000], with a cut-off value of 1.39, sensitivity of 0.833, and specificity of 0.479. Cox regression analysis suggested that NLR (N1: Wald = 9.262, p = 0.010, N2: HR = 12.267, 95%CI 2.432-61.863, p = 0.000, and N3: HR = 8.142, 95%CI 1.209-77.754, p = 0.032) was associated with poor efficacy at discharge. Elevated NLR was considered as an independent risk factor of poor outcomes during discharge.

Conclusion

NLR could reflect disease severity and short time curative effect in children with MG to some extent. It may also be a potential marker in indicating diagnosis and severity of MG in children.

中文翻译：

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中性粒细胞/淋巴细胞比值与儿童重症肌无力存在及短期疗效的相关性回顾性研究

摘要

目标

本研究旨在探讨中性粒细胞与淋巴细胞比率（NLR）对儿童重症肌无力（MG）严重程度和短期疗效的影响。

方法

回顾性分析132例MG儿童资料，收集同期140例健康对照（HC组）资料。对两组数据进行比较和分析。

结果

MG组的NLR显着高于HC组（Z  =2.644，p  =0.008）。根据NLR水平，将患者分为3组：N1（NLR < 1.03）、N2（NLR 1.03-2.17）和N3（NLR > 2.17）。观察3组间白细胞计数、病程、尿酸、白蛋白及住院时间的显着差异（p  < 0.05、0.01）。Logistic回归结果显示，NLR（调整后OR=3.874，95%CI 1.359-11.045，p  =0.011）是MG的危险因素，是入院时QMG较高的危险因素（调整后OR=2.989，95% CI 1.247-7.160, p = 0.014）。使用 NLR 水平进行 MG 诊断测试，受试者工作特征 (ROC) 曲线下面积为 0.765 [95%CI (0.710-0.820), p  = 0.000]，截断值为 1.39，灵敏度为 0.833 ，特异性为 0.479。Cox回归分析表明，NLR（N1：沃尔德= 9.262，p  = 0.010，N2：HR = 12.267，95％CI 2.432-61.863，p  = 0.000，和N3：HR = 8.142; 95％CI 1.209-77.754，p  = 0.032) 与出院时疗效差有关。NLR 升高被认为是出院期间预后不良的独立危险因素。

结论

NLR可以在一定程度上反映MG患儿的病情严重程度和短期疗效。它也可能是指示儿童 MG 诊断和严重程度的潜在标志物。