新型冠状病毒肺炎患者法维拉韦相关血尿酸升高的发生情况及影响因素分析  被引量:1

Incidence and influencing factors of favipiravir-associated serum uric acid elevation in patients with coronavirus disease 2019

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作  者:钱芳 徐艳利 宋美华 田地 任兴翔 葛子若 张婷玉 王爱彬 韩冰 陈志海 Qian Fang;Xu Yanli;Song Meihua;Tian Di;Ren Xingxiang;Ge Ziruo;Zhang Tingyu;Wang Aibin;Han Bing;Chen Zhihai(Department of Infectious Diseases,National Clinical Key Specialty for Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区:[1]首都医科大学附属北京地坛医院感染性疾病诊疗中心,感染病科国家临床重点专科,北京100015

出  处:《药物不良反应杂志》2022年第4期169-174,共6页Adverse Drug Reactions Journal

基  金:国家重点研发计划(2020YFC0848300)。

摘  要:目的探讨应用法维拉韦治疗的新型冠状病毒肺炎(COVID-19)患者血尿酸升高发生情况及其影响因素。方法收集2020年6月1日至2021年6月30日在北京地坛医院住院并应用法维拉韦5日或10日方案治疗的COVID-19患者的病历资料进行回顾性分析。以法维拉韦用药结束后血尿酸变化率≥30%为血尿酸升高,据此将患者分为血尿酸升高组与无血尿酸升高组,比较2组患者的临床特征(性别、年龄、体重指数、合并疾病情况、吸烟饮酒情况、COVID-19分型、法维拉韦用药方案、用药前血尿酸和肾功能等),采用logistic多因素回归方法分析法维拉韦相关血尿酸升高的影响因素。结果纳入分析的患者为179例,男性104例(58.1%),女性75例(41.9%);年龄19~70岁,中位年龄43岁。179例患者法维拉韦治疗后血尿酸水平比治疗前明显升高[(451±119)μmol/L比(332±94)μmol/L,P<0.001];血尿酸变化率为-57.1%~157.8%,中位血尿酸变化率为38.6%;108例(60.3%)患者血尿酸变化率≥30%。接受法维拉韦5日和10日方案治疗患者血尿酸升高发生率分别为46.8%(36/77)和70.6%(72/102),差异有统计学意义(P=0.001)。多因素logistic回归分析显示,体重指数24.0~<28.0 kg/m2(OR=3.109,95%CI:1.209~7.994,P=0.019)和法维拉韦10日方案(OR=3.017,95%CI:1.526~5.964,P=0.001)是法维拉韦相关血尿酸升高的独立危险因素。结论应用法维拉韦治疗的COVID-19患者超过半数可发生血尿酸升高,超重和法维拉韦10日方案是血尿酸升高的独立危险因素。Objective To explore the occurrence and influencing factors of serum uric acid elevation in patients with coronavirus disease 2019(COVID-19)treated with favipiravir.Methods Medical records of patients with COVID-19 who were hospitalized in Beijing Ditan Hospital between June 1,2020 and June 30,2021 and treated with the 5-or 10-day regimen of favipiravir were collected and retrospectively analyzed.After favipiravir withdrawal,if the elevation in serum uric acid was≥30%of baseline level,it was defined as serum uric acid elevation.Then patients were divided into serum uric acid elevation group and non-serum uric acid elevation group.The clinical characteristics such as gender,age,body mass index,comorbidities,smoking and drinking behavior,COVID-19 grade,favipiravir regimen,and serum uric acid level and renal function before treatment in patients between the 2 groups were compared.Influencing factors of favipiravir-associated serum uric acid elevation was analyzed using multivariate logistic regression method.Results A total of 179 patients were included in the analysis,including 104(58.1%)males and 75(41.9%)females,aged from 19 to 70 years with a median age of 43 years.The level of serum uric acid in 179 patients after favipiravir treatment was significantly higher than before[(451±119)μmol/L vs.(332±94)μmol/L,P<0.001].The change rate of serum uric acid from baseline level ranged from-57.1%to 157.8%with the median of 38.6%.The elevation in serum uric acid of≥30%of baseline level occurred in 108(60.3%)patients.The incidences of serum uric acid elevation in patients treated with 5-day and 10-day regimens of favipiravir were 46.8%(36/77)and 70.6%(72/102),respectively,and the difference between them was significant(P=0.001).Multivariate logistic regression analysis showed that body mass index 24.0 to<28.0-kg/m2(OR=3.109,95%CI:1.209-7.994,P=0.019)and 10-day regimen of favipiravir(OR=3.017,95%CI:1.526-5.964,P=0.001)were independent risk factors for favipiravir-associated serum uric acid elevation.Conclusions More

关 键 词:新型冠状病毒肺炎 尿酸 高尿酸血症 药物相关副作用和不良反应 法维拉韦 

分 类 号:R563.1[医药卫生—呼吸系统]

 

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