Kawasaki disease can be combined with liver injury. As a mainstay treatment for Kawasaki disease, aspirin may cause liver injury. This study aimed to compare the safety and effectiveness of clopidogrel versus aspirin in Kawasaki disease with mild-to-moderate liver injury. This study retrospectively analysed 166 children with Kawasaki disease combined with mild-to-moderate liver injury. The children treated with clopidogrel were less likely to have aggravated liver injury than those treated with aspirin (n = 2/100 vs. n = 13/66, P < 0.001). The initial alanine aminotransferase value of the clopidogrel group was higher (131.5 [98.5, 167.5] vs. 96 [72, 133], P < 0.001), while the time of alanine aminotransferase recovery to normal was similar (5 [4, 7] vs. 4 [3, 7], P = 0.179). No significant fever differences observed between groups: 7.5 [6, 9] for aspirin vs. 7 [6, 8] for clopidogrel group, P = 0.064. The probability of nonresponse to intravenous immunoglobulin (n = 29/100 vs. n = 30/66, P = 0.030) and the days of hospitalization (n = 6 [4, 9] vs. n = 7 [5, 10], P = 0.007) in the clopidogrel group were less than those in the aspirin group. In conclusion, the application of clopidogrel is potentially superior to aspirin in Kawasaki disease combined with mild-to-moderate liver injury.

川崎病可合并肝损伤。作为川崎病的主要治疗药物，阿司匹林可能会导致肝损伤。本研究旨在比较氯吡格雷与阿司匹林治疗伴有轻至中度肝损伤的川崎病的安全性和有效性。本研究回顾性分析了166例患有川崎病合并轻中度肝损伤的儿童。与接受阿司匹林治疗的儿童相比，接受氯吡格雷治疗的儿童出现严重肝损伤的可能性较小（n = 2/100 vs. n = 13/66，P  < 0.001）。氯吡格雷组初始丙氨酸转氨酶值较高（131.5 [98.5, 167.5] vs. 96 [72, 133]，P  < 0.001），而丙氨酸转氨酶恢复正常的时间相似（5 [4, 7]）与 4 [3, 7]，P  = 0.179）。组间未观察到显着的发热差异：阿司匹林组为 7.5 [6, 9]，氯吡格雷组为 7 [6, 8]，P  = 0.064。对静脉注射免疫球蛋白无反应的概率（n = 29/100 vs. n = 30/66，P  = 0.030）和住院天数（n = 6 [4, 9] vs. n = 7 [5, 10]，P  = 0.007）氯吡格雷组低于阿司匹林组。总之，氯吡格雷在川崎病合并轻中度肝损伤中的应用可能优于阿司匹林。