A Meta-analysis Of Prevention And Treatment Of Coronary Artery Lesion Of Kawasaki Disease By Intravenous Immunoglobulin

Objective:To evaluate and analyze the therapeutic effects of different dose of IVIG on KD, especially the precaution of KD coronary damage and the curative effect analysis of treatment.Methods:Based on the inclusion and exclusion criteria to screen related RCT literature from Jan. 2000 to Dce. 2015 among the Medical electronic databases, including Pub Med, Mediline, Elsevier, VIP, CNKI and Wan- fang database, a quality assessment is carried out according to Cochrane Handbook for Systematic Reviews of Intervention and then a meta-analysis is conducted by the software Review Manager 5.0 to investigate the therapeutic effects of IVIG on KD. The main judgment index of the outcome measurement is the coronary artery lesion according to the echocardiogram; and the secondary indexes are the hospital stays, the fever clearance time, adverse reaction, deflorescence, CRP ESR, etc. The results are showed by 95% CI and there is significant difference when P<0.05.Results:According to include exclusion criteria, a total of 18 RCT papers on screen, a total of 1790 cases, the results found that ivig 2 g/Kg single dose group and 1 g/Kg.(d) * 1 compared to 2 d group, there was no statistically significant difference ratio of coronary artery injury [MD = 0.81, 95% CI(0.60, 0.60), p = 0.19), 2 g/Kg single dose group and 1 g/Kg.(d) * 1-2 d group than in coronary artery damage rate was statistically difference in [MD = 0.57, 95% CI(0.35, 0.35), p = 0.03).1 g/Kg.(d) * 1 to 2 d group and 400 mg/Kg.(d) * 4-5 d group than in coronary artery damage rate was statistically difference in [MD = 0.58, 95% CI(0.37, 0.37), p =0.02].Conclusions: There are 18 RCT articles altogether 1790 cases being screened out according to the inclusion and exclusion criteria. The results indicate that compared with the 1g/(kg.d)*1-2d group, the 2g/kg IVIG single dose group has no significant difference in the coronary artery lesion rate, lesion severity and clinical symptom recovery(p<0.05) and that compared with the 1g/(kg.d)*1-2d group and the 2g/kg single dose group, the 400mg/(kg.d)*4-5d group has significant difference in the coronary artery lesion rate and the clinical symptom recovery.