摘要
目的:探讨华法林治疗川崎病合并巨大冠状动脉瘤(GA)的有效性及安全性。方法:回顾性分析2010年1月至2019年4月在我院确诊并接受治疗的川崎病合并GA患儿病例资料,收集华法林联合阿司匹林治疗与单用阿司匹林患儿的用药剂量、疗程、凝血功能、心电图改变、心脏彩超、出血事件及血栓事件等进行分析。结果:共收集病例42例,男33例,女9例,年龄2.56(0.82,5.93)岁,华法林钠联合阿司匹林抗凝组(联合组)29例,单用阿司匹林抗凝组(阿司匹林组)13例。两组患儿比较,联合组凝血酶原时间(PT)(20.01±5.47)秒、活化部分凝血酶原时间(APTT)(47.82±9.50)秒和国际标准化比值(INR)1.69±0.57,均高于阿司匹林组的(12.73±1.10)秒、(38.16±5.64)秒和0.92±0.76(P<0.05);联合组有20例出血事件,均为小出血,阿司匹林组无出血事件;联合组血栓形成事件1例,阿司匹林组血栓形成事件11例,差异有统计学意义(P<0.05)。出血事件的受试者工作特征(ROC)曲线,诊断发生出血事件的敏感度为60.0%,特异度为85.0%;血栓事件的ROC曲线,诊断发生血栓事件的敏感度为83.0%,特异度为70.0%。结论:INR在1.52~2.25时,华法林联合阿司匹林治疗川崎病合并GA是安全有效的。
Objective:To explore the efficacy and safety of warfarin in the treatment of Kawasaki disease complicated with giant coronary artery aneurysm(GA).Methods:Retrospective analysis was performed on children with Kawasaki disease complicated with GA diagnosed and treated in our hospital from Jan.2010 to Apr.2019.The dosage,course of treatment,coagulation function,electrocardiographic changes,doppler echocardiography,bleeding events and thrombotic events of warfarin combined with aspirin or aspirin alone in children were collected and analyzed.Results:A total of 42 cases were enrolled,including 33 males and 9 females,aged 2.56(0.82,5.93)years,there were 29 cases in warfarin sodium combined with aspirin anticoagulant group(combined group)and 13 cases in aspirin anticoagulant group(aspirin group).Prothrombin time(PT),activated partial prothrombin time(APTT)and international normalized ratio(INR)in the combined group were respectively(20.01±5.47)seconds,(47.82±9.50)seconds and 1.69±0.57,higher than(12.73±1.10)seconds,(38.16±5.64)seconds and 0.92±0.76 in the aspirin group(P<0.05).Totally 20 cases of bleeding events were observed in the combined group,all of which were minor bleeding,and there were no bleeding events in the aspirin group.Totally one case of thrombotic event were observed in the combined group and 11 cases in the aspirin group,with statistically significant differences(P<0.05).The sensitivity and specificity of receiver operating characteristic(ROC)curve for the diagnosis of bleeding events were respectively 60.0%and 85.0%.ROC curve of thrombotic events showed the sensitivity of 83.0%and specificity of 70.0%.Conclusion:Warfarin combined with aspirin is safe and effective in the treatment of Kawasaki disease complicated with GA when the INR is from 1.52 to 2.25.
作者
向金星
肖政辉
王丹
肖云彬
杨舟
左超
王祥
陈智
Xiang Jinxing;Xiao Zhenghui;Wang Dan;Xiao Yunbin;Yang Zhou;Zuo Chao;Wang Xiang;Chen Zhi(Hunan Children’s Hospital,Hunan Changsha 410007,China)
出处
《儿科药学杂志》
CAS
2021年第11期4-7,共4页
Journal of Pediatric Pharmacy
关键词
华法林
川崎病
巨大冠状动脉瘤
warfarin
Kawasaki disease
giant coronary artery aneurysm
