Low-dose Aspirin In Treating Kawasaki Disease Based On Platelet Aggregation By Arachidonic Acid Monitoring

Objective:To observe the effect and side effects of low dose aspirin on Kawasaki disease in children under the monitoring of arachidonic acid(A.A.)Participants and methods: a total of 554 children with KD/IKD diagnosed and treated in the Pediatric Department of a Hospital from 2020.3 to 2022.8 were analyzed retrospectively,including 350 males and 204 females,aged from 2 months to11 years,with a median of 2 years and 6 months.All cases were diagnosed and treated according to the guidelines for diagnosis and treatment of Kawasaki disease in children in 2017 in the United States and the sixth edition in Japan.According to the condition of coronary artery injury,the patients were divided into two groups: normal coronary artery(CAN)group and coronary artery lesion(CAL)group.According to the dose of Asp,the patients were divided into observation group(n= 253),Asp was reduced to 1.5-2.5mg / kg·d-1 at the 2nd week keeping A.A.less than 20%.Those take the traditional dose of 3-5mg/kg.d-1 of Asp all the time were the control group(n= 301).CAN children only take Asp orally,those with small / moderate coronary artery aneurysm(CAA)clopidogrel added,and those with giant CAA,warfarin added.Results:(1)the incidence of bleeding(epistaxis,gingiva,conjunctiva and bruising of skin over than the diameter of 1cm)in observation group was lower than that in control group(P < 0.05).(2)Under the premise of keep INR2.0-3.0,coronary artery thrombosis diminished or disappeared in observation group,there is no recurrence of thrombus,and there was no significant difference at the incidence of CAA thrombosis between two groups(P > 0.05).(3)After reducing the dose of Asp,there was no new occurrence of CAL in observation group.(5)In patients with CAL,there was no significant difference at recovering of CAL between the two groups,P>0.05.Conclusion:(1).According to A.A.tapering Asp from 3-5mg/kg·d-1 to 1.5-2.5mg/ kg·d-1 does not effect either the incidence of CAL,or the recovery of CAA,while it can reduced the formation of thrombus in CAA for reducing bleeding and increasinglong-term compliance of medicine in CAA children.(2)It is important to keep INR2.0-3.0 by take Wafarin and then it does not increase thrombus in KD children by reducing Asp to 1.5-2.5mg/ kg·d-1 according to A.A.