摘要
目的评价真实世界中洛匹那韦/利托那韦(LPV/r)及阿比多尔治疗新型冠状病毒肺炎(COVID-19)的疗效和安全性。方法回顾性分析2020年1月20日至2月10日广州市第八人民医院收治的确诊为COVID-19的178例患者临床资料,根据患者的抗病毒治疗方案,分为LPV/r组59例、阿比多尔组36例、LPV/r与阿比多尔合用组25例及未使用任何抗病毒药物的常规治疗组58例。主要观察终点为咽拭子新型冠状病毒核酸转阴时间。结果LPV/r组、阿比多尔组、合用组及常规治疗组患者治疗前基线情况差异无统计学意义;咽拭子新型冠状病毒核酸转阴时间分别为(10.20±3.49)、(10.11±4.68)、(10.86±4.74)、(8.44±3.51)d,各组间差异无统计学意义(F=2.556,P=0.058),且咽拭子新型冠状病毒核酸转阴率、临床症状改善率及肺部感染影像学改善率也无明显差别(P>0.05)。但4组治疗7d由普通/轻型转为重型/危重型的比例存在统计学意义的差异(χ2=9.311,P=0.017):合用组(24.0%,6/25),阿比多尔组(16.7%,6/36),LPV/r组(5.4%,3/56),常规治疗组(5.2%,3/58)。使用抗病毒药物的3组患者发生不良反应的频率显著高于常规治疗组(χ2=14.875,P=0.002)。结论未发现LPV/r和阿比多尔能促进COVID-19患者咽拭子病毒核酸转阴或改善症状,联用LPV/r和阿比多尔可能不利于病情改善,尤其需注意抗病毒药物的不良反应。
Objective To evaluate the efficacy and safety of lopinavir/ritonavir(LPV/r)and arbidol in treating patients with coronavirus disease 2019(COVID-19)in the real world.Methods The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10,2020 were retrospectively analyzed.According to patient′s antiviral treatment regimens,178 patients were divided into 4 groups including LPV/r group(59 patients),arbidol group(36 patients),LPV/r plus arbidol combination group(25 patients)and the supportive care group without any antiviral treatment(58 patients).The primary end point was the negative conversion time of nucleic acid of 2019 novel coronavirus(2019-nCoV)by pharyngeal swab.Results The baseline parameters of 4 groups before treatment was comparable.The negative conversion time of viral nucleic acid was(10.20±3.49),(10.11±4.68),(10.86±4.74),(8.44±3.51)days in LPV/r group,arbidol group,combination group,and supportive care group respectively(F=2.556,P=0.058).There was also no significant difference in negative conversion rate of 2019-nCoV nucleic acid,the improvement of clinical symptoms,and the improvement of pulmonary infections by CT scan(P>0.05).However,a statistically significant difference was found in the changing rates from mild/moderate to severe/critical type at day 7(χ2=9.311,P=0.017),which were 24%(6/25)in combination group,16.7%(6/36)in arbidol group,5.4%(3/56)in LPV/r group and 5.2%(3/58)in supportive care group.Moreover,the incidence of adverse reactions in three antiviral groups was significantly higher than that in supportive care group(χ2=14.875,P=0.002).Conclusions Antiviral treatment including LPV/r or arbidol or combination does not shorten the negative conversion time of 2019-nCoV nucleic acid nor improve clinical symptoms.Moreover,these antiviral drugs cause more adverse reactions which should be paid careful attention during the treatment.
作者
温春燕
谢志伟
李粤平
邓西龙
陈晓婷
曹意
欧旭
林伟寅
李锋
蔡卫平
李凌华
Wen Chunyan;Xie Zhiwei;Li Yueping;Deng Xilong;Chen Xiaoting;Cao Yi;Ou Xu;Lin Weiyin;Li Feng;Cai Weiping;Li Linghua(Infectious Disease Center,Guangzhou Eighth People′s Hospital,Guangzhou 510060,China;Intensive Care Unit,Guangzhou Eighth People′s Hospital,Guangzhou 510060,China;Institute of Infectious Diseases,Guangzhou Eighth People′s Hospital,Guangzhou 510060,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2020年第8期605-609,共5页
Chinese Journal of Internal Medicine
基金
广州市高水平临床重点专科传染科(2019-2021)。
