氯吡格雷辅助治疗儿童丙种球蛋白无反应型川崎病的临床效果

目的:探讨氯吡格雷辅助治疗对丙种球蛋白无反应型川崎病患儿近期疗效、症状缓解时间及炎性因子指标水平的影响.方法:选取72例静脉注射丙种球蛋白无反应型川崎病患儿,随机分为观察组和对照组各36例.对照组采用阿司匹林联合双嘧达莫辅助丙种球蛋白治疗,观察组在对照组治疗基础上加用氯吡格雷,比较两组患儿的近期疗效、主要临床症状的缓解...

Clinical Effects of Clopidogrel in Adjuvant Treatment of Children with Intravenous Immunoglobulin-Resistant Kawasaki Disease

Objective:To probe into the effects of clopidogrel treatment on short-term efficacy,relief time of symptoms and inflammatory factors in children with intravenous immunoglobulin-resistant Kawasaki disease.Methods:A total of 72 children with intravenous immunoglobulin-resistant Kawasaki disease were extracted to be divided into the observation group and the control group,with 36 cases in each group.The control group was treated with aspirin combined with dipyridamole-assisted gamma globulin,while the observation group received clopidogrel based on the control group.The short-term efficacy,relief time of symptoms,white blood cell count(WBC),platelet count(PLT),C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),and tumor necrosis factorα(TNF-α),high mobility group protein B1(HMGB1),and macrophage migration inhibitory factor(MIF)before and after treatment in two groups were compared.The incidence of coronary artery dilatation,coronary aneurysm and adverse drug reactions in two groups were analyzed.Results:There was no significant difference in the total effective rate between two groups(P>0.05).The duration of fever,disappearance time of enlargement of cervical lymph nodes,disappearance time of diffuse mucosal congestion and remission time of trunk erythema in the observation group were significantly shorter than those in the control group(P<0.05).The levels of WBC,PLT,CRP,PCT,IL-6,TNF-α,HMGB1 and MIF in the observation group after treatment were significantly lower than those in the control group(P<0.05).The incidence of coronary artery dilation in the observation group was 8.33%,significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse drug reactions between two groups(P>0.05).Conclusion:Clopidogrel in adjuvant treatment of children with intravenous immunoglobulin-resistant Kawasaki disease can improve the short-term efficacy,shorten the relief time of symptoms and reduce the inflammatory response and coronary artery injury with higher safety.