What is the cure rate for early stage Kawasaki disease?

What is the cure rate of early Kawasaki disease? I believe many people would like to know. In fact, Kawasaki disease is a particularly common disease. When a child is sick, he will be particularly painful. As parents, we feel distressed but don’t know how to deal with it. Therefore, we must learn more about relevant knowledge. Let us learn about the treatments of this disease together. Let’s take a look.

1. Acute Phase Treatment

1. Recent studies on immunoglobulin have confirmed that early intravenous infusion of immunoglobulin plus oral aspirin can reduce the incidence of Kawasaki disease coronary artery aneurysm. It must be emphasized that medication should be used within 10 days after onset. The dosage is daily intravenous infusion of immunoglobulin 400 mg/kg, infused over 2 to 4 hours, for 4 consecutive days; at the same time, oral aspirin 50 to 100 mg/kg·d, divided into 3 to 4 times, for 4 consecutive days, and then increased to 5 mg/kg·d, taken all at once.

2. Aspirin. Early oral aspirin can control the acute inflammatory process and reduce coronary artery lesions, but no controlled studies have shown that aspirin treatment can reduce the incidence of coronary artery aneurysms. The dosage is 30-100 mg/kg per day, divided into 3-4 times. Japanese doctors tend to use small doses, based on the fact that those who take large doses during the acute phase of Kawasaki disease believe that acute patients have reduced aspirin absorption and increased clearance, and only large doses can achieve anti-inflammatory effects. Take it for 14 days, and after the fever subsides, reduce it to 3-5 mg/kg per day, taken once, and the anti-platelet aggregation effect is fully achieved.

3. Corticosteroids: It has always been believed that adrenal cortex hormones have strong anti-inflammatory effects and can relieve symptoms. However, it was later found that corticosteroids are prone to thrombosis, hinder the repair of coronary artery lesions, and promote aneurysm formation. Therefore, it is not appropriate to use corticosteroids such as prednisone alone for treatment. Unless there is a complication of severe myocarditis or persistent high fever in severe cases, prednisone and aspirin can be used in combination for treatment. In order to control the early inflammatory response of Kawasaki disease, corticosteroids are generally not used alone.

2. Treatment during the recovery period

1. Anticoagulant therapy: For cases in the recovery stage, take aspirin 3-5 mg/kg per day, once a day, until the erythrocyte sedimentation rate and platelet count return to normal. If there is no coronary artery abnormality, the drug is generally discontinued 6-8 weeks after onset. Repeat echocardiograms 6 months and 1 year thereafter. For patients with residual chronic coronary artery disease, long-term anticoagulant drugs and close follow-up are required. Patients with small single coronary artery aneurysms should take aspirin 3-5 mg/kg·d for a long time until the aneurysm disappears. For those who are intolerant to aspirin, 3-6 mg/kg per day can be used, divided into 2-3 doses. Heart condition every year. If echocardiogram, clinical data or exercise test indicate myocardial ischemia, coronary angiography should be performed. Patients with multiple or larger coronary aneurysms should take angiography orally for a long time. Patients with multiple or larger coronary aneurysms should take aspirin and dipyridamole orally for a long time. Patients with giant tumors are prone to thrombosis, coronary artery stenosis or occlusion, and can use oral warfarin anticoagulants. These patients should limit their activities and not participate in sports. Check the heart every 3 to 6 months. If there are signs of myocardial ischemia or a positive exercise test, coronary angiography should be performed to understand the progression of stenosis. Patients with occlusion of one or more major coronary arteries should receive long-term anticoagulant therapy, repeated heart examinations, including myocardial scanning, exercise testing, coronary angiography, etc., and consider surgical treatment.

2. Thrombolytic therapy: For patients with myocardial infarction and thrombosis, intravenous or percutaneous catheter puncture is used to administer drugs into the coronary artery to promote coronary recanalization and myocardial reperfusion. Intravenous thrombolysis is performed within 1 hour with urokinase 20,000u/kg, followed by 3,000-4,000u/kg per hour. Intracoronary artery administration is performed within 1 hour with urokinase 1,000u/kg. Streptokinase can also be used, intravenous thrombolysis is performed within 1 hour with streptokinase 10,000u/kg, and it can be used again half an hour later. The above drugs quickly dissolve fibrin, with good effects and no adverse reactions.

After reading the introduction in the above article, we all know the treatments for Kawasaki disease. Parents and friends must learn more about the relevant knowledge. When children become ill, don’t worry too much. Get timely treatment and strengthen nursing care. They should also eat more fruits and vegetables, and avoid eating peppers.