Fatma Yazılıtaş, Evrim Kargın Çakıcı, Ayse Secil Eksioglu, Tülin Güngör, Evra Çelikkaya, Deniz Karakaya, Çiğdem Üner, Mehmet Bülbül
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引用次数: 0
Abstract
Introduction: A high vesicoureteral reflux (VUR) grade is among the specific risk factors for febrile urinary tract infection (febrile UTI) and renal scarring. The aim of this study was to examine the predictive value of some potential hematological parameters for high-grade VUR and renal scarring in children 2 to 24 months old with febrile UTI.
Methods: We retrospectively examined the clinical features, laboratory tests, and imaging studies of 163 children 2 to 24 months old with a diagnosis of febrile UTI. The hematological parameters based on the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and white blood cell count (WBC) were calculated using a receiver operating characteristic (ROC) analysis to select which one is suitable.
Results: Of the 163 children with febrile UTI, 57 patients (35%) exhibited high-grade VUR. Regarding the predictive power for high-grade VUR, the median area under the curve (AUC) was 0.692 for NLR (sensitivity 61.4%, specificity 69.8%, P < 0.001) and 0.681 for PLR (sensitivity 63.2%, specificity 62.3%, P < 0.001). White blood cell count demonstrated the highest area under the ROC curve for diagnosis of high-grade VUR (0.884, 95% confidence interval 0.834-0.934) and an optimal cutoff value of 13.5 (sensitivity 80.7%, specificity 80.2%, P < 0.001). White blood cell count, with the highest AUC of 0.892 while the sensitivity and specificity were 83.3% and 82.8, was the preferred diagnostic index for renal scarring screening.
Conclusions: White blood cell count, NLR, and PLR were useful biomarkers closely related to children with febrile UTI who are at risk for high-grade VUR can also act as a novel marker to accurate prediction of high-grade VUR and renal scarring. Also, NLR and PLR can serve as useful diagnostic biomarkers to distinguish high-grade VUR from low-grade VUR.
导读:高膀胱输尿管反流(VUR)等级是发热性尿路感染(发热性UTI)和肾瘢痕形成的特定危险因素之一。本研究的目的是研究一些潜在的血液学参数对2至24个月大发热性尿路感染患儿高级别VUR和肾瘢痕形成的预测价值。方法:我们回顾性分析163例2 ~ 24月龄诊断为发热性尿路感染的儿童的临床特征、实验室检查和影像学检查。根据中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和白细胞计数(WBC)计算血液学参数,采用受试者工作特征(ROC)分析来选择合适的血液学参数。结果:163例发热性尿路感染患儿中,57例(35%)表现为高级别VUR。对于高级别VUR的预测能力,NLR的中位曲线下面积(AUC)为0.692(敏感性61.4%,特异性69.8%,P P P)结论:白细胞计数、NLR和PLR是与有高级别VUR风险的发热UTI患儿密切相关的有用生物标志物,也可作为准确预测高级别VUR和肾瘢痕形成的新标志物。此外,NLR和PLR可以作为区分高级别VUR和低级别VUR的有用诊断生物标志物。