川崎病抗凝治疗的指征及应用

Indication and application of anticoagulation therapy in Kawasaki disease

川崎病血管炎介导的凝血功能异常,以及冠状动脉内血流动力学变化,使冠状动脉内血栓形成的风险增加。因此,川崎病抗凝治疗非常重要。治疗指征和疗程基于冠状动脉严重程度分级,所有川崎病患儿均需接受抗血小板治疗,冠状动脉病变达到Ⅲ级者需接受两种以上抗血小板药物;Ⅳ级以上者需阿司匹林联合华法林抗凝治疗;合并血栓形成及心肌梗死者需及早给予溶栓治疗;抗凝治疗疗程至少需持续3个月,如果冠状动脉病变持续存在需长期抗凝治疗。

The abnormal coagulation function mediated hy vasculitis associated with Kawasaki disease and abnormal hemodynamics in coronary artery lesions will increase the risk of thrombosis in coronary artery, so anticoagulation therapy in Kawasaki disease is very important. The indications is based on the risk stratification of coronary artery. All children with Ka- wasaki disease should accept antiplatelet therapy. Patients with risk level Ⅲ should accept more than two kinds of antiplatelet drugs, patients with risk level Ⅳ and above should take aspirin and warfarin together, and patients with thrombo- sis and myocardial infarction should be given thrombolysis therapy early. Anticoagulation treatment should last at least 3 months. If the coronary artery persists, long term anticoagulant therapy should be performed.