青蒿琥酯治疗新型冠状病毒肺炎的临床研究  

Clinical study of artesunate in the treatment of coronavirus disease 2019

作　　者：林艳荣 吴锋耀 谢周华 宋晓玲 朱庆东 韦静 谭仕稷 梁联哨 龚贝贝 Lin Yanrong;Wu Fengyao;Xie Zhouhua;Song Xiaoling;Zhu Qingdong;Wei Jing;Tan Shiji;Liang Lianshao;Gong Beibei(Department of Intensive Care Unit,Nanning Fourth People's Hospital,Affiliated Infectious Disease Hospital of Guangxi Medical University,Nanning 530023,Guangxi Zhuang Autonomous Region,China;Department of Anesthesiology,Nanning Fourth People's Hospital,Affiliated Infectious Disease Hospital of Guangxi Medical University,Nanning 530023,Guangxi Zhuang Autonomous Region,China;Department of Tuberculosis,Nanning Fourth People's Hospital,Affiliated Infectious Disease Hospital of Guangxi Medical University,Nanning 530023,Guangxi Zhuang Autonomous Region,China;Department of Pediatrics,Nanning Fourth People's Hospital,Affiliated Infectious Disease Hospital of Guangxi Medical University,Nanning 530023,Guangxi Zhuang Autonomous Region,China;Department of Nursing,Nanning Fourth People's Hospital,Affiliated Infectious Disease Hospital of Guangxi Medical University,Nanning 530023,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]南宁市第四人民医院(广西医科大学附属南宁市传染病医院)ICU,南宁530023 [2]南宁市第四人民医院(广西医科大学附属南宁市传染病医院)麻醉科,南宁530023 [3]南宁市第四人民医院(广西医科大学附属南宁市传染病医院)结核科,南宁530023 [4]南宁市第四人民医院(广西医科大学附属南宁市传染病医院)儿科,南宁530023 [5]南宁市第四人民医院(广西医科大学附属南宁市传染病医院)护理部,南宁530023

出　　处：《中华危重病急救医学》2020年第4期417-420,共4页Chinese Critical Care Medicine

基　　金：广西壮族自治区新型冠状病毒感染的肺炎疫情应急科技攻关专项(2020AB39022)。

摘　　要：目的探讨青蒿琥酯治疗新型冠状病毒肺炎(简称新冠肺炎)的有效性。方法采用前瞻性研究方法,选择2020年1月22日至2月15日南宁市第四人民医院收治的43例新冠肺炎确诊患者作为研究对象,按入院单双号顺序将患者分为常规治疗组(25例)和青蒿琥酯联合治疗组(18例)。常规治疗组按指南推荐给予洛匹那韦/利托那韦500 mg+α-干扰素500×104 U雾化吸入,每日2次;青蒿琥酯联合治疗组在常规治疗基础上静脉注射青蒿琥酯60 mg,每日2次,两组疗程均为10 d。治疗期间每隔2 d进行1次咽拭子新型冠状病毒(2019-nCoV)核酸检测,复查血常规、肝肾功能、凝血功能及心肌酶;治疗开始每3 d检查1次胸部CT,病情好转后每5 d复查1次。比较两组患者的血常规及生化指标的变化,以及两组患者症状明显改善时间、咽拭子病毒核酸转阴时间、肺部病灶吸收时间、用药不良反应及住院天数,以此评估疗效。结果两组患者的性别、年龄、体重等一般资料及治疗前血常规和生化指标比较差异均无统计学意义。治疗后青蒿琥酯联合治疗组症状明显改善时间(d:3.33±1.91比4.84±2.19)、2019-nCoV核酸检测转阴时间(d:4.72±2.16比6.68±3.76)、肺部病灶开始吸收时间(d:5.39±2.36比7.48±3.78)、病灶吸收>70%时间(d:14.11±4.16比17.04±4.42)以及住院时间(d:16.56±3.71比18.04±3.97)均明显短于常规治疗组,差异均有统计学意义(均P<0.05);但两组药物不良反应发生率比较差异无统计学意义(72.2%比80.0%,P>0.05)。结论青蒿琥酯能缩短新冠肺炎患者的治疗时间,改善预后和清除病原体,不良反应少,有很好的应用前景。Objective To discuss the effective of artesunate in the treatment of coronavirus disease 2019(COVID-19).Methods Using prospective method,the 43 cases of confirmed COVID-19 patients in Nanning Fourth People's Hospital from January 22nd to February 15th in 2020 were enrolled and divided into routine treatment group(n=25)and artesunate treatment group(n=18)by odd-even rule after admission.According to the guidelines,the routine treatment group was recommended to receive lopinavir/ritonavir 500 mg+α-aerosolized interferon 500×104 U,twice daily;the artesunate treatment group was given artesunate 60 mg,twice daily besides the routine treatment,for 10 days in both groups.During the treatment period,the pharynx swab test of 2019 novel coronavirus(2019-nCoV)nucleic acid was carried out every 2 days,and the routine blood test,liver and kidney functions,blood coagulation function and myocardial enzymes were re-examined.Chest CT was checked every 3 days after the treatment,and re-examined every 5 days after the condition was improved.The routine blood test and biochemical results of two groups were observed,and the efficacy evaluation was performed by monitoring the time for significant improvement of symptoms,negative conversion time of throat swab virus nucleic acid,lung lesion absorption time,adverse drug reactions and the length of hospital stay of the two groups.Results There were no significant differences between the two groups in terms of gender,age,body weight,routine blood test and biochemical results before treatment.In artesunate treatment group,the time for significant improvement of symptoms(days:3.33±1.91 vs.4.84±2.19),negative conversion time of 2019-nCoV nucleic acid(days:4.72±2.16 vs.6.68±3.76),lung lesion absorption starting time(days:5.39±2.36 vs.7.48±3.78),lung lesion absorption greater than 70%time(days:14.11±4.16 vs.17.04±4.42)and the length of hospital stay(days:16.56±3.71 vs.18.04±3.97)were significantly shorter than those in routine treatment group,with significant differences(all P<0.05

关 键 词：青蒿琥酯 新型冠状病毒肺炎 治疗 

分 类 号：R563.1[医药卫生—呼吸系统]