Immunoglobulin Combined With Corticosteroid In The Treatment Of Kawasaki Disease: A Mety-analysis

Objective: We performed this meta analysis to compare the incidence of coronary abnormality between intravenous immunoglobulin(IVIG)plus corticosteroid therapy and IVIG therapy alone for the initial treatment of Kawasaki disease.Methods: A select of clinical trials was conducted in the main database about the IVIG plus corticosteroid therapy as the initial treatment of Kawasaki disease at first. After the literature screening and quality evaluation, we picked up the datas about design feature, intervening measures, coronary artery abnormalities,severe adverse events and so on.Finally, the datas was analyzed by Revman5.3.Results: Ten literatures were selected, including 1227 patients.Ten literatures consisted of six randomized controlled trials and four case-control studies. The meta-analysis came out three results.(1)The IVIG plus corticosteroid therapy as the initial treatment of Kawasaki disease can reduce the incidence of coronary artery abnormality(OR=0.33,95%CI[0.16,0.68],Z=3.02,P=0.002<0.005=.(2)The IVIG pluscorticosteroid therapy as the initial treatment of Kawasaki disease which had the high risk of IVIG resistance can reduce the incidence of coronary artery abnormality(OR=0.20,95%CI[0.10,0.36],Z=5.16,P<0.00001).(3)The incidence of severe adverse events in the IVIG plus corticosteroid group and the IVIG group were similar(OR=1.38,95%CI[0.36,0.5.35],Z=0.47,P=0.64>0.05).Conclusion:(1)The IVIG plus corticosteroid therapy as the initial treatment of Kawasaki disease can reduce the incidence of coronary artery abnormality.(2)The IVIG plus corticosteroid therapy as the initial treatment of Kawasaki disease which had the high risk of IVIG resistance can reduce the incidence of coronary artery abnormality.(3)The incidence of severe adverse events in the IVIG plus corticosteroid group and the IVIG group were similar...