硫酸羟氯喹联合阿奇霉素治疗难治性普通型新型冠状病毒肺炎的临床疗效及安全性  

Clinical efficacy and safety of hydroxychloroquine sulfate combined with azithromycin in treatment of patients with refractory common coronavirus disease 2019

作　　者：吴梅红 王斌[2] 刘鹏 盛华[1,4] 张锚 李强 蔡晨 WU Mei-hong;WANG Bin;LIU Peng;SHENG Hua;ZHANG Mao;LI Qiang;CAI Chen(Department of Infectious Diseases(Ⅰ),Guanggu Branch of Maternity and Child Healthcare Hospital of Hubei Province,Wuhan 430073,Hubei,China;Department of Oncology,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of Colorectal Surgery,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of Cardiology,No.63600 Troop Hospital of PLA,Lanzhou 730070,Gansu,China;Department of Neurosurgery,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of VIP Medicine,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]湖北省妇幼保健院光谷院区感染一科,武汉430073 [2]海军军医大学(第二军医大学)长海医院肿瘤科,上海200433 [3]海军军医大学(第二军医大学)长海医院肛肠外科,上海200433 [4]解放军63600部队医院心内科,兰州732750 [5]海军军医大学(第二军医大学)长海医院神经外科,上海200433 [6]海军军医大学(第二军医大学)长海医院特需诊疗科,上海200433

出　　处：《第二军医大学学报》2020年第6期612-615,共4页Academic Journal of Second Military Medical University

摘　　要：目的初步评价硫酸羟氯喹联合阿奇霉素治疗难治性普通型新型冠状病毒肺炎(COVID-19)患者的临床疗效及安全性。方法回顾性收集2020年3月22日至25日湖北省妇幼保健院光谷院区治疗的11例难治性普通型COVID-19患者资料。联合治疗方案:硫酸羟氯喹200 mg每天3次口服(第1~7天);阿奇霉素500 mg每天1次口服(第1天),250 mg每天1次口服(第2~4天)。在给药后第4~10天连续复查咽拭子严重急性呼吸综合征冠状病毒2(SARS-CoV-2)核酸,给药前3 d内及给药后第8天进行血常规等实验室检查。结果11例COVID-19患者均为普通型,其中7例为SARS-CoV-2核酸检测持续阳性患者,4例为核酸检测复阳患者。联合给药前11例患者的平均病程为50.2 d。治疗过程顺利,给药后第4天咽拭子SARS-CoV-2核酸转阴0例,第5天转阴2例,第6天转阴2例,第7天转阴2例,第8天转阴1例,第9天转阴1例。11例患者均未进展为重型或危重型,未观察到明显不良反应。结论硫酸羟氯喹联合阿奇霉素方案对于接受多种治疗失败、SARS-CoV-2核酸检测持续阳性的难治性普通型COVID-19患者安全有效。Objective To evaluate the clinical efficacy and safety of hydroxychloroquine sulfate combined with azithromycin in the treatment of refractory common coronavirus disease 2019(COVID-19)patients.Methods The clinical data of 11 refractory common COVID-19 patients,who were admitted to Guanggu Branch of Maternity and Child Healthcare Hospital of Hubei Province from Mar.22 to 25,2020,were retrospectively collected.The patients all received combined treatment regimens:hydroxychloroquine sulfate orally 200 mg three times daily for 7 days;and azithromycin orally 500 mg once daily on day 1 and then 250 mg once daily from day 2 to day 4.The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid test of throat swab was performed once daily from day 4 to day 10 after combined administration,and the blood routine and other laboratory indicators were tested within 3 days before administration and on the 8th days after administration.Results All the 11 patients had common COVID-19,seven of them were consistently positive for SARSCoV-2 nucleic acid test,and four were positive again after negative results.The average course of disease of 11 patients before combined administration was 50.2 days.The treatment process was uneventful.Zero case of SARS-CoV-2 nucleic acid test result turned negative on day 4 after administration,two cases on day 5,two cases on day 6,two cases on day 7,one case on day 8 and one case on day 9.No patients progressed to severe or critical illness,and no severe side effects were found.Conclusion Hydroxychloroquine sulfate combined with azithromycin is safe and effective in the treatment of refractory common COVID-19 patients who have failed in other treatments and are consistently positive for SARS-CoV-2 nucleic acid.

关 键 词：新型冠状病毒肺炎 普通型 难治性 羟氯喹 阿奇霉素 转阴率 

分 类 号：R511[医药卫生—内科学]