阿司匹林对川崎病患儿抗血小板聚集功能的研究

目的　评估阿司匹林在川崎病患儿中的抗血小板聚集功能。方法　回顾性分析2016年9月至2018年9月北京大学首都儿科研究所教学医院收治的川崎病患儿的临床资料。所有患儿常规给予阿司匹林治疗，急性期为大剂量（30～50） mg/（kg·d），恢复期为小剂量（3～5） mg/（kg·d）， 应用光学比浊法（light transmission aggregometry， LTA）测定应用不同剂量阿司匹林的血小板聚集率以评价其抗血小板聚集功能， 并用统计学方法分析发生阿司匹林抵抗（aspirin resistance，AR）的危险因素。结果　（1）川崎病患儿口服大剂量和小剂量阿司匹林治疗后的血小板聚集率（AA%）分别为 3.3 %（1.2%， 7.1%）及2.9%（1.5%， 6.4%）， 不同剂量阿司匹林对血小板的抑制作用（AA%）差异无统计学意义（P＝0.174）。（2）大剂量阿司匹林组AR发生率为9.75%（23/236）， 小剂量阿司匹林组AR发生率为8.05 %（19/236）， 二者差异无统计学意义（P＝0.617）。（3）小剂量阿司匹林组中19例存在AR与217例阿司匹林敏感（aspirin sensitivity， AS）患儿的年龄、 性别及凝血、 生化等相关指标差异无统计学意义。结论　阿司匹林对川崎病患儿抗血小板聚集功能与剂量无关。在川崎病治疗中存在AR，AR发生率与剂量无关。

Effect of aspirin on anti-platelet aggregation function in children with Kawasaki disease

Objective　To evaluate the anti-platelet aggregation function of aspirin in children with Kawasaki disease（KD）. Methods　The clinical data of KD patients who was admitted to Capital Institute of Pediatrics-Peking University Teaching Hospital from September 2016 to September 2018 was retrospectively analyzed. All the children were treated with aspirin routinely：high-dose（30-50） mg/（kg·d） in acute stage and low-dose aspirin（3-5） mg/（kg·d） in the recovery period. Then the light transmission aggregometry（LTA）was used to determine the platelet aggregation rate of different doses of aspirin in order to evaluate the anti-platelet aggregation function， and the risk factors of aspirin resistance（AR） were analyzed by statistical method. Results　（1）The platelet aggregation rate（AA%） after treatment with high-dose and low-dose aspirin in children with KD was 30.3%（1.2%，7.1%） and 2.9%（1.5%，60.4%），respectively，and there was no significant difference in platelet inhibition between different doses of aspirin（P＝0.174）. （2）The incidence of AR was 9.75%（23/236） in the high-dose aspirin group and 8.05%（19/236） in the low-dose aspirin group. There was no significant difference in the incidence of AR between the two groups（P＝0.617）. （3）In the 19 children with AR and 217 children with aspirin sensitivity（AS） in oral low-dose aspirin treatment group，the age，sex，coagulation，biochemistry and other related indexes did not significantly differ between the two groups. Conclusion　The anti-platelet aggregation function of aspirin in KD children is not related to the dosage. AR is present in the treatment of Kawasaki disease，and the incidence of aspirin resistance is not related to dosage.