Kawasaki disease (KD) is an acute febrile illness of unknown etiology and predictors for intravenous immunoglobulin (IVIG) resistance have been widely explored in recent decades. Neutrophil to lymphocyte platelet ratio (NLPR) was reported to be associated with the outcomes in many diseases. However, its relationship with IVIG resistance has not be explored. The medical data of patients diagnosed with KD in Children’s Hospital of Soochow University between January 2019 and December 2020 were retrospectively reviewed and analyzed. Patients were trisected into three groups based on NLPR. Logistics regression was used to analyze the association between NLPR and IVIG resistance. Restricted cubic spine was used to exhibit the relationship. Sensitivity analysis and subgroup analysis were also carried out. A total of 803 patients were included in the present study (61.8% males; median age: 24 months). IVIG resistance occurred in 74 (9.2%) patients. Multivariable-adjusted analyses revealed higher NLPR (odds ratio [95% confidence interval]: 1.12 [1.00-1.24]) was an independent predictor of IVIG resistance, which was strengthened by sensitivity analyses. The association of NLPR and IVIG resistance was not modified by age, sex, CALs, or days of IVIG initiation ≤ 4. NLPR may be a valuable prognostic marker in KD patients with IVIG resistance.

中文翻译：

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预测川崎病的免疫球蛋白抵抗：评估中性粒细胞与淋巴细胞血小板的比率

川崎病 (KD) 是一种病因不明的急性发热性疾病，近几十年来已广泛探索了静脉注射免疫球蛋白 (IVIG) 耐药性的预测因子。据报道，中性粒细胞与淋巴细胞血小板比率 (NLPR) 与许多疾病的结果相关。然而，其与 IVIG 耐药性的关系尚未探索。回顾分析苏州大学附属儿童医院2019年1月至2020年12月诊断为KD患者的医疗资料。根据 NLPR，患者被分为三组。逻辑回归用于分析 NLPR 和 IVIG 耐药性之间的关联。受限的立方脊柱被用来展示这种关系。还进行了敏感性分析和亚组分析。本研究共纳入 803 名患者（61.8% 为男性；中位年龄：24 个月）。74 名 (9.2%) 患者发生 IVIG 耐药。多变量调整分析显示较高的 NLPR（比值比 [95% 置信区间]：1.12 [1.00-1.24]）是 IVIG 耐药的独立预测因子，敏感性分析加强了这一点。NLPR 和 IVIG 耐药性的相关性不受年龄、性别、CAL 或 IVIG 起始天数≤ 4 的影响。NLPR 可能是具有 IVIG 耐药性的 KD 患者的一个有价值的预后标志物。