Abstract：Objective To investigate the clinical efficacy of glucocorticoid combined with ulinastatin in the treatment of Kawasaki disease (KD) in children. Methods A total of 104 children who were admitted and diagnosed with typical KD between January 2011 and December 2013 were assigned to ulinastatin group (methylprednisolone + ulinastatin; n=46) and intravenous immunoglobulin (IVIG) group (n=58) according to the severity of KD and the willingness of their parents. Observations for the two groups were performed to compare the changes in coronary artery diameter before and at 1 week, 3 months, and 6 months after treatment, fever clearance time, retreatment condition, changes in white blood cells (WBC), platelets (PLT), hemoglobin (HB), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) at 1 week and 3 weeks after treatment, and total in-hospital cost. Results There was no significant difference in the coronary artery diameter between the two groups before or at 1 week, 3 months or 6 months after treatment (P> 0.05). All the patients (100%) in the ulinastatin group vs 83% in the IVIG group had a normal body temperature after 48 hours of treatment (PPPConclusions For children with KD, methylprednisolone combined with ulinastatin does not increase the risk of coronary artery aneurysm, decreases in-hospital costs, is superior in controlling laboratory markers and shortening the duration of fever during the acute phase compared with the IVIG therapy.
. Glucocorticoid combined with ulinastatin in treatment of Kawasaki disease in children: a non-randomized controlled clinical trial[J]. CJCP, 2015, 17(8): 780-785.
Fury W, Tremoulet AH, Watson VE, et al. Transcript abundance patterns in Kawasaki disease patients with intravenous immunoglobulin resistance[J]. Hum Immunol, 2010, 71(9): 865-873.
[2]
Nakamum Y, Yashiro M, Uehara R, et al. Epidemiologic features of Kawasaki disease in japan: resuits of the 2009-2010 nationwide survey[J]. J Epidemiol, 2012, 22(3): 216-221.
Research Committee of the Japanese Society of Pediatric Cardiology; Cardiac Surgery Committee for Development of Guidelines for Medical Treatment of Acute Kawasaki Disease. Guidelines for medical treatment of acute Kawasaki disease: report of the Research Committee of the Japanese Society of Pediatric Cardiology and Cardiac Surgery (2012 revised version)[J]. Pediatr Int, 2014, 56(2): 135-158.
[13]
Ayusawa M, Sonobe T, Uemura S, et a1. Revision of diagnostic guidelines for Kawasaki disease(the 5th revised edition)[J]. Pediatr Int, 2005, 47(2): 232-234.
Sundel RP, BakerAL, Fulton DR, et al. Corticosteroids in the initial treatment of Kawasaki disease: report of a randomized trial[J]. J Pediatr, 2003, 142(6): 611-616.
Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association[J]. Circulation, 2004, 110(17): 2747-2771.
[28]
Liakopoulos OJ, Sehmitto JD, Kazanaier S, et al. Cardiopulmonary and systemic effects of methylperdniisolone in patients undergoing eardiac surgery[J]. Arm Thorac Surq, 2007, 84(1): 110-119.
