PDF(Pubmed)
Abstract：
This systematic review and meta-analysis assesses the effectiveness of no or low-dose versus high-dose aspirin on the incidence of coronary artery aneurysms (CAAs), intravenous immunoglobulin (IVIG) resistance, hospital stay length, and fever duration during the acute phase of Kawasaki disease. Our review adheres to the Preferred Reporting Items for Systematic Reviews guidelines. The PubMed and Google Scholar databases were comprehensively searched to identify relevant studies in the literature, including observational studies and randomized controlled trials (RCTs). The primary outcome was the incidence of CAAs. The secondary outcomes were the hospital stay length, fever duration, and IVIG resistance. The risk of bias was assessed using the Newcastle-Ottawa scale for cohort studies and Cochrane\'s Risk of Bias Tool for RCTs. The data were analyzed using the Review Manager software. Twelve studies with a total of 68,495 participants met the inclusion criteria. The incidences of CAAs (odds ratio [OR] = 0.93; 95% confidence interval [CI] = 0.64-1.34) and IVIG resistance (OR = 1.46; 95% CI = 1.00-2.12) did not differ significantly between no or low-dose versus high-dose aspirin in treating acute KD. Moreover, the fever durations (mean difference [MD] = 3.55 h; 95% CI = -7.99-15.10) and hospital stay lengths (MD = -0.54 days; 95% CI = -2.50-1.41) were similar in the no and low-dose aspirin group compared to the high-dose aspirin group. Our review indicates that there are no significant differences in the incidences of CAA and IVIG resistance, fever durations, and hospital stay lengths between no or low-dose versus high-dose aspirin in treating the acute phase of KD.
摘要：
这项系统评价和荟萃分析评估了无或低剂量阿司匹林与高剂量阿司匹林对冠状动脉瘤（CAA）发生率的有效性。静脉免疫球蛋白（IVIG）耐药性，住院时间,川崎病急性期的发热持续时间。我们的审查遵循系统审查的首选报告项目指南。对PubMed和GoogleScholar数据库进行了全面搜索，以确定文献中的相关研究，包括观察性研究和随机对照试验（RCTs）。主要结果是CAAs的发生率。次要结果是住院时间，发烧持续时间，和IVIG抵抗。使用队列研究的纽卡斯尔-渥太华量表和随机对照试验的Cochrane的偏倚风险工具评估偏倚风险。使用ReviewManager软件分析数据。共有68,495名参与者的12项研究符合纳入标准。CAAs（比值比[OR]=0.93;95％置信区间[CI]=0.64-1.34）和IVIG抵抗（OR=1.46;95％CI=1.00-2.12）的发生率在无或低剂量阿司匹林治疗急性KD与高剂量阿司匹林之间没有显着差异。此外，与高剂量阿司匹林组相比,无剂量和低剂量阿司匹林组的发热持续时间(平均差异[MD]=3.55h;95%CI=-7.99~15.10)和住院时间(MD=-0.54日;95%CI=-2.50~1.41)相似.我们的审查表明，CAA和IVIG耐药性的发生率没有显着差异，发烧持续时间，在治疗KD急性期时，无阿司匹林或低剂量阿司匹林与高剂量阿司匹林之间的住院时间。
