The Study Of Efficacy Of IVIG Combined With Different Doses Of Aspirin In The Treatment Of Kawasaki Disease

Objective: To collect clinical data of 273 children with acute Kawasaki disease,and to explore the efficacy of gamma globulin combined with different doses of aspirin in the treatment of Kawasaki disease.Methods: A total of 273 children with Kawasaki disease diagnosed in Shenzhen Children’s Hospital from January 2021 to October 2022 were retrospectively collected.All the children were included using the diagnostic criteria of the 5th revision in Japan in 2002,excluding incomplete Kawasaki disease,severe infection,suspected drug allergy,pre-existing coronary artery damage before admission,gamma globulin,hormone therapy in the course of disease,high-risk Kawasaki disease,and incomplete clinical and laboratory data.In the acute stage of the disease,two doses of aspirin were given on the basis of IVIG treatment.According to different doses of aspirin,273 children were divided into two groups,i.e.,135 cases in the high-dose group(IVIG2g/kg+ 30-50 mg /(kg·d)aspirin).And low-dose group(IVIG2g/kg+3 ～ 5mg/(kg·d)aspirin)138 cases,then the coronary artery damage,acute cardiovascular events,clinical efficacy,adverse reactions and other aspects of the two groups were tracked,observed and followed up.The difference of hospitalization days,clinical symptoms(time of fever reduction,heat course),laboratory indexes(leukocyte,CRP,neutrophil ratio,hemoglobin,platelet)and acute cardiovascular complications between the low-dose group and the high-dose group was compared.Cardiac color ultrasound was reviewed at1 month,2 months and 3 months after discharge,respectively.Follow-up was conducted to compare the coronary artery damage between the two groups.Results: 1.The total duration of fever after medication was shortened between the lowdose group and the high-dose group,and the difference was statistically significant(p<0.05).There was no significant difference in the duration of fever reduction and the length of hospital stay between the two groups after medication(p>0.05).2.Laboratory indexes such as leukocyte,neutrophil ratio and CRP were not significantly different between the low-dose group and the high-dose group before treatment,while CRP in both groups decreased after treatment,and there were differences before and after comparison in the same group,and the degree of change in the high-dose group was less obvious than that in the dose group,the difference was statistically significant(p<0.05);There was no statistical significance in the recovery of inflammatory indexes between high-dose and low-dose groups after treatment(p>0.05).3.The incidence of acute cardiovascular and cerebrovascular complications(pericardial effusion,valvular regurgitation,left ventricular dysfunction)was compared between the two groups,and there was no statistical significance between the two groups.There were 19 cases(2.8%)with coronary artery changes in the low-dose group and 18 cases(2.6%)with coronary artery changes in the high-dose group.There was no significant difference in the incidence of coronary artery damage between the low-dose group and the high-dose group(p>0.05).4.The absolute value and z value of coronary inner diameter of patients with coronary artery damage were compared between the two groups,and there was no statistical significance in the outcome between the two groups within 3 months(p>0.05).Conclusion:1.There was no significant difference between the two groups after treatment with IVIG2g/kg combined with high-dose aspirin and IVIG2g/kg combined with low-dose aspirin in the number of days in hospital,the time of fever reduction after treatment,and the recovery of inflammatory indicators;2.Compared with the treatment with low-dose aspirin,IVIG2g/kg combined with high-dose aspirin could shorten the fever course.Inflammatory markers decreased more significantly,but the shortened heat course was short and the difference between the two groups was not clinically significant.3.There is no significant difference between IVIG2g/kg combined with highdose aspirin and low-dose combined with low-dose aspirin in the occurrence of acute cardiovascular complications and prognosis of coronary artery damage in Kawasaki disease;...