Analysis Of The Efficacy Of Dipyridamole In The Adjuvant Treatment Of Kawasaki Disease In Different Periods

Objective: To collect the clinical data of 60 children with Kawasaki disease and retrospectively analyze the efficacy of dipyridamole as an adjuvant treatment in different stages of Kawasaki disease.Methods: The clinical data of 60 children with Kawasaki disease who were hospitalized in Changchun Children’s Hospital from October 2019 to June 2022 were collected.All children were included in the criteria for Kawasaki disease in the6 th revised diagnostic criteria for Kawasaki disease in Japan in 2020,excluding the following categories: children with primary cardiovascular disease;Children allergic to gamma globulin,aspirin,and dipyridamole;Children with other immune system diseases;Children who did not use gamma globulin or aspirin;Children with coagulopathy;Children with other bacterial infections;Children with incomplete clinical and laboratory data.According to whether to give dipyridamole in the early stage,children in the control group were divided into two groups.Children in the control group were given gamma globulin 1 g/kg for two consecutive days;Aspirin30-50mg/kg/d,gradually reduced to 3-5 mg/kg/d within 2 weeks after the fever subsided for 3 days.The observation group took dipyridamole 5mg/kg,3/d orally on the basis of the control group.Both groups were treated for 8 weeks.The observation group and the control group were compared before and after treatment in terms of the time for clinical symptoms to subside(time for fever to subside,time for swelling of hands and feet to subside,time for changes in oral and labial mucosa to subside),the level of inflammatory factors(WBC,CRP,PCT,ESR,PLT),and the level of coagulation factors(PT,APTT,FIB,D-dimer).Follow up the results of color Doppler ultrasound in the second,sixth,and first months after discharge of the two groups of children,and compare the incidence of coronary artery damage between the two groups.Result:1.Time for clinical symptoms to subside: Compared with the control group,the observation group significantly shortened the time for fever,hand and foot swelling to subside,and the time for changes in oral and lip mucosa to subside,with a statistically significant difference(p<0.05).2.Changes in inflammatory factors(WBC,CRP,PCT,ESR,PLT): Intragroup comparison: After treatment,both groups were lower than before treatment,with statistically significant differences(p<0.05);Inter group comparison: There was no significant difference between the two groups before treatment,but after treatment,the observation group was significantly lower than the control group,with a statistically significant difference(p<0.05).3.Changes in coagulation factors(PT,APTT,FIB,D-dimer): Intragroup comparison: After treatment,both groups were significantly lower than before treatment,with significant differences(p<0.05);Inter group comparison: There was no significant difference between the two groups before treatment.After treatment,FIB and D-dimer in the observation group were significantly lower than those in the control group,with a statistically significant difference(p<0.05).After treatment,there was no statistically significant difference in APTT and PT between the observation group and the control group(p>0.05).4.Changes in total clinical effective rate: The total clinical effective rate in the observation group was 96.7%,while the total clinical effective rate in the control group was 93.3%,with no statistically significant difference(p>0.05).5.Follow up: According to the statistics of cardiac color Doppler ultrasound results during treatment and 1 year after discharge,there were 0 cases with coronary artery changes in the observation group and 2 cases(93.3%)with coronary artery changes in the control group,with no statistically significant difference(p>0.05).Conclusion:1.Early adjuvant treatment with dipyridamole for Kawasaki disease results in faster remission of clinical symptoms.2.In the early adjuvant treatment of Kawasaki disease with dipyridamole,the decrease of inflammatory factors and some coagulation factors(FIB,D-dimer)was more significant.3.There is no significant difference between the overall clinical efficacy of dipyridamole in early adjuvant treatment of Kawasaki disease and the prognosis of coronary artery damage.