Abstract:

Objective To explore the predictive value of neutrophil-to-albumin ratio for convulsions with mild gastroenteritis (CwG) accompanied by reversible splenial lesion syndrome (RESLES) in children，and provide a reference for early identification of high-risk child patients. Methods A total of 40 patients with CwG accompanied by RESLES were retrospectively enrolled as the study group, who were treated in the Department of Pediatrics of Shanxi Bethune Hospital from January 2017 to June 2025, and 63 CwG patients without RESLES hospitalized in the same period were selected as control group. The clinical characteristics and laboratory data of the two groups were analyzed. Results （1）There were no significant differences between the study group and the control group in terms of age, gender, BMI, presence or absence of fever, number of vomiting, number of diarrhea, duration of seizures, frequency of seizures, history of previous seizures and family history(P>0.05).（2）The platelet count, blood sodium, and albumin in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05).The neutrophil count and CRP in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05).The positive detection rate of fecal rotavirus antigen in the study group was higher than that in the control group, and the difference was statistically significant(P<0.05).（3）Composite indicators of blood inflammation: The neutrophil percentage/albumin count(NPAR), neutrophil count × monocyte count/lymphocyte count(SIRI), neutrophil count/lymphocyte count (NLR) and CRP × neutrophil count/lymphocyte count(IBI) in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05).The lymphocyte count×albumin count/neutrophil count(LANR) and albumin/fibrinogen(AFR) in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05).（4）Multivariate analysis showed that NPAR and the positivity of intestinal rotavirus antigen were independent risk factors for CwG acompanied by RESLES in children. A receiver operating characteristic curve (ROC) for NPAR yielded a 0.848 of the area under the curve, with the optimal cutoff value being 12.92, predictive sensitivity being 80.0%, and specificity being 74.6%. Conclusion High NPAR level and positive rotavirus antigen are independent risk factors for CwG acompanied by RESLES in children. The level of NPAR has certain predictive value for CwG acompanied by RESLES.

Key words: Convulsion with mild gastroenteritis, Reversible splenial lesion syndrome, Neutrophil, Albumin, Child