Meta-analysis Of The Efficacy Of Ulinastatin In The Treatment Of Children With Kawasaki Disease

Objective This study analyzed the therapeutic effect of Ulinastatin(UTI)in children with Kawasaki disease(including KD resistant to IVIG or KD without response to IVIG),and provided evidence-based evidence for the use of Ulinastatin in the clinical treatment of Kawasaki disease patients.Methods A comprehensive search of Pub Med,CNKI,CBM,Cochranelibrary,VIP,and Wanfang databases was conducted,and all randomized controlled trials(RCTs)of ulinastatin adjuvant therapy published between January 2000 and December 2020 were searched.By sifting through information such as title,Keywords Abstract out inappropriate literature,by reading the full text extraction literature has again of ulinastatin antifebrile time after treatment of kawasaki disease,the incidence of CAA,hematology indexes results data,such as research involves interventions ulinastatin,aspirin treatment as well as the classic aspirin + immunoglobulin and aspirin + armor prednisolone sodium succinate + immunoglobulin solution treatment.The RCTs that met the inclusion criteria were evaluated for their quality.Finally,the outcome indicators of the 11 RCTs that met the inclusion criteria for 983 pediatric patients with Kawasaki disease were Meta-analyzed respectively.Results Ulinastatin adjuvant therapy was statistically significant in reducing the incidence of coronary artery injury.Ulinastatin adjuvant therapy can significantly affect the incidence of coronary artery injury.Ulinastatin can significantly reduce the incidence of coronary artery injury(OR0.85,95%CI: 0.52-1.33,P=0.51,I2=0%)and accelerate the recovery process of children.Random-effect model was used to analyze the effect of ulinastatin adjuvant therapy on the antipyretic time of children with Kawasaki disease in 11 articles.The analysis results showed that there was a statistical difference in the antipyretic time of Ulinastatin treatment for Kawasaki disease(OR=0.75,95%CI: 0.43-1.20,P=0.18,I2=0%).The two groups were compared in terms of the time of fever abatement.After 24 hours of treatment for Kawasaki disease,the decrease rate of body temperature in the Ulinastatin group was faster than that in the observation group.Meta-analysis of 11 RCT comparing ulinastatin treatment in laboratory tests including the WBC,PLT,CRP,calcitonin original(PCT)and blood sedimentation improve level were significantly better than the control group,the WBC index data,for example,heterogeneity inspection results: P = 0.38 > 0.05,the fixed effects model Meta analysis is adopted,the results showed that ulinastatin auxiliary treatment of kawasaki disease can effectively improve the laboratory indexes of indirect evidence ulinastatin can effectively control the disease progression.Conclusions Ulinastatin in the treatment of children with Kawasaki disease can shorten the duration of fever,improve the level of laboratory indicators,reduce the degree of coronary artery injury,and have no side effects such as liver damage.