Effect of different doses of intravenous immunoglobulin combined with Aspirin in the treatment of Kawasaki disease in children and its impact on coronary artery Z values and vascular endothelial function

LU Bingxiu; NIU Lili; DING Guofu

doi:10.3969/j.issn.1002-3429.2026.04.011

Abstract：Objective To investigate the efficacy of different doses of intravenous immunoglobulin(IVIG)combined with Aspirin in the treatment of Kawasaki disease(KD)in children and its effect on coronary artery Z values vascular endothelial function,and coagulation function.Methods A total of 206 children with KD who were hospitalized from May 2020 to May 2023 were enrolled as the study subjects,and were grouped by the random number table method,with 103 patients in each group.Both groups were treated with Aspirin,the control group was supplemented with low-dose IVIG on this basis,and the observation group was supplemented with high-dose IVIG.The treatment period was 3 weeks,and clinical efficacy,coronary artery Z values,vascular endothelial function and coagulation function,and inflammatory factor levels before and after treatment,as well as the time to resolution of clinical symptoms and signs,and the incidence of adverse reactions,were compared between the two groups.Results The total clinical efficacy in the observation group was higher than that in the control group(P＜0.05).After treatment,the coronary artery Z values were significantly higher than those before treatment,while the non-flow mediated dilation(NMD)and brachial artery blood flow-mediated dilation(FMD)were significantly higher than those before treatment(P＜0.05).Compared with the control group,the observation group showed reduced coronary artery Z values and increased NMD and FMD after treatment(P＜0.05,P＜0.01).There was no significant difference in activated partial thromboplastin time between the two groups before and after treatment(P＞0.05).After treatment,the levels of D-dimer(D-D),white blood cell count(WBC),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)in both groups were lower than those before treatment(P＜0.05).The levels of D-D,WBC,CRP,and ESR in the observation group after treatment were lower than those in the control group(P＜0.05,P＜0.01).The time to resolution of clinical symptoms and signs in the observation group was shorter than that in the control group(P＜0.05).In addition,there were no significant differences in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion High-dose IVIG combined with Aspirin for children with KD has a more significant efficacy,which can rapidly reduce inflammatory response,improve vascular endothelial function,coagulation function and coronary artery lesions,shorten the course of the disease,and has good safety.