International Journal of Pediatrics Research

Objective To explore the clinical significance of peripheral blood neutrophil to lymphocyte ratio (NLR), Urinary Micro-globulin (MALB) and D-dimer in children with anaphylactoid purpura. Methods The data of 100 children with henoch-schonlein purpura admitted from December 2017 to December 2022 in our department of pediatrics were retrospectively analyzed, including the counts of white blood cells, neutrophils, lymphocytes, monocytes, CRP, platelets, D-dimers, serum creatinine, urinary micro-protein and NLR. The risk factors of renal damage were analyzed by logistic regression, and the clinical efficacy of various indicators of renal damage was evaluated by ROC curve. Results WBC, NEU, PLT, NLR, MALB, D-dimer in HSP group were higher than those in healthy control group, and HSPN group was higher than those in HSP non-renal damage group, with statistical significance (P<0.05). Logistic regression analysis showed that NLR (OR=1.051, P<0.015), MALB (OR=3.897, P<0.05),D-dimer(OR=1.074,P<0.05),were risk factors for renal damage in anaphylactoid purpura. The ROC curve showed that the AUC detected by NLR, MALB, D-dimer and their combination were 0.859、0886、0.756、0.897， respectively. Among the single indicators, the AUC area of MALB was the largest, with its specificity of 78.7% and sensitivity of 84.0%; The AUC area of three combined tests was larger than that of a single index, with sensitivity of86.5% and specificity of 77.5%. Conclusion: NLR, MALB and blood D-dimer are independent risk factors for HSPN. In the early assessment of renal damage caused by HSP, MALB has the highest value, and the combined detection of the three indicators is more significant than a single indicator.

Children allergic purpura; Renal damage; Hyperlipidemia; The ratio of neutrophils and lymphocytes; The urine trace globulin; Blood D – dimer