Finkelstein Yaron, Nurmohamed Laila, Avner Marina, Benson Lee N, Koren Gideon
Division of Clinical Pharmacology, The Hospital for Sick Children, University of Toronto School of Medicine, Toronto, Ontario.
J Pediatr. 2005 Nov;147(5):657-61. doi: 10.1016/j.jpeds.2005.05.006.
To review a pediatric experience with the antiplatelet agent clopidogrel and suggest a dosage regimen.
A retrospective chart review of all infants and children treated with clopidogrel at The Hospital for Sick Children, Toronto between January 2001 and April 2004. Clopidogrel dosages, duration of therapy, complications, and adverse effects in a pediatric population were explored.
Fifteen infants and children with congenital and acquired heart disease were treated with clopidogrel (median age, 3.5 years; range, 6 weeks to 16 years). Dosages ranged from 1 to 6 mg/kg/day for periods between 1 month and 6 months. Although no thrombotic events were reported, 1 child had a bleeding complication (gastrointestinal) while on triple antithrombotic therapy. Other complications reported in adults, including rash and clinical thrombocytopenia, were not noted in this pediatric series.
Clopidogrel was well tolerated. We suggest a starting dose of 1 mg/kg/day for children.
回顾小儿使用抗血小板药物氯吡格雷的经验并提出给药方案。
对2001年1月至2004年4月间在多伦多病童医院接受氯吡格雷治疗的所有婴幼儿和儿童进行回顾性病历审查。探讨了小儿群体中氯吡格雷的剂量、治疗持续时间、并发症及不良反应。
15例患有先天性和后天性心脏病的婴幼儿和儿童接受了氯吡格雷治疗（中位年龄3.5岁；范围6周至16岁）。剂量为1至6毫克/千克/天，治疗时间为1个月至6个月。虽然未报告血栓形成事件，但1例患儿在接受三联抗血栓治疗时出现出血并发症（胃肠道）。本小儿系列未发现成人中报告的其他并发症，包括皮疹和临床血小板减少症。
氯吡格雷耐受性良好。我们建议儿童起始剂量为1毫克/千克/天。
