Correlation Analysis Between D-dimer/fibrinogen Ratio,Albumin/fibrinogen Ratio and Systemic Juvenile Idiopathic Arthritis with Macrophage Activation Syndrome
Objective:To explore the correlation between D-dimer/fibrinogen ratio(DFR),albumin/fibrinogen ratio(AFR)and systemic juvenile idiopathic arthritis(sJIA)with macrophage activation syndrome(MAS).Methods:Sixty-eight newly diagnosed sJIA patients at Henan Children's Hospital from January 2017 to June 2022 were selected as the sJIA group,and 32 sJIA patients combined with MAS were selected as the MAS group.Collect clinical manifestations and laboratory indicators within 24 hours of diagnosis of sJIA and MAS in pediatric patients and compare them.The correlation between DFR,AFR and laboratory indicators was analyzed using Spearman correlation analysis.The value of DFR and AFR in the diagnosis of sJIA combined with MAS was evaluated by drawing receiver operating characteristic curves(ROCs).Results:① The levels of fibrinogen and serum albumin in the MAS group were significantly lower than those in the sJIA group,while D-dimer,DFR,and AFR were significantly higher than those in the sJIA group,with statistical significance(P＜0.01).② DFR and AFR were positively correlated with aspartate aminotransferase,alanine aminotransferase,lactate dehydrogenase,triglycerides,and serum ferritin,while negatively correlated with C-reactive protein,erythrocyte sedimentation rate,white blood cell count,and platelet count,with statistically significant differences(P＜0.05).③Multiple linear regression analysis showed an independent correlation(P＜0.05)between the diagnosis of AFR and sJIA combined with MAS.④According to the ROC curve,the optimal cutoff values for DFR and AFR in diagnosing sJIA combined with MAS were 0.86 and 11.16,respectively(sensitivity 92.6%,specificity 85.7%,AUC=0.956;sensitivity 97.1%,specificity 78.6%,AUC=0.946).The combined diagnostic sensitivity of DFR and AFR was 94.1%(specificity 92.9%,AUC=0.98).Conclusion:DFR and AFR are related to the activity of sJIA combined with MAS,and their combined detection is helpful for the early diagnosis of MAS.
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