가와사키병의 급성기 치료에서 고용량 아스피린과 이부프로펜의 사용효과 비교 연구

Abstract

Objective Reye’s syndrome can be caused by high dose of aspirin which is for treatment of acute phase of Kawasaki disease. We evaluated the effectiveness of treatment and coronary complications of replacing high dose of aspirin with ibuprofen for children in acute phase of Kawasaki disease. Methods Children with Kawasaki disease (n = 235) were admitted in the pediatric department from January 1, 2015 to December 31, 2017. Echocardiography and laboratory tests were performed during admission, and the children were followed-up at 6–8 weeks after the onset. We retrospectively analyzed their characteristics and clinical outcomes. Results The children were assigned to receive either high dose of aspirin with intravenous immunoglobulin (IVIG) (aspirin group) or ibuprofen with IVIG (ibuprofen group). A total of 119 and 116 children were included in the aspirin and ibuprofen groups. Total fever duration was 6.5 ± 1.6 days in the aspirin group, and 6.5 ± 1.7 days in the ibuprofen group (P=0.674). The number of resistance to initial treatments was 11 in the aspirin group and 11 in the ibuprofen group (P=0.571). There were 13 initial coronary complications in the aspirin group, and 10 in the ibuprofen group (P=0.552) and children who showed coronary artery abnormalities improvement at 6- to 8-week follow-up was seven and five in the aspirin and ibuprofen groups, respectively (P=0.769). Conclusion We may consider using ibuprofen in acute phase of Kawasaki disease to prevent the severe complications of aspirin use, such as Reye’s syndrome in the case concerning influenza or varicella.