洛匹那韦/利托那韦联合α-干扰素治疗新型冠状病毒感染的疗效及对免疫功能的影响  

Effect of lopinavir/ritonavir combined with interferon-αin treatment of 2019-ncov infection and its effect on immune function

作　　者：倪薪 王茜 曲英杰 倪茗[2] NI Xin;WANG Qian;QU Yingjie;NI Ming(Department of Respiratory and Critical Care Medicine,Hongqi Hospital Affiliated to Mudanjiang Medical College,Mudanjiang,Heilongjiang 157000,China;Department of Gastroenterology,the First People's Hospital of Mudanjiang,Mudanjiang,Heilongjiang 157000,China)

机构地区：[1]牡丹江医学院附属红旗医院呼吸与危重症医学科,黑龙江牡丹江157000 [2]牡丹江市第一人民医院消化内科,黑龙江牡丹江157000

出　　处：《检验医学与临床》2024年第2期203-207,212,共6页Laboratory Medicine and Clinic

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(2020-KYYWFMY-0018)。

摘　　要：目的探讨洛匹那韦/利托那韦(LPV/r)联合α-干扰素(INF-α)治疗新型冠状病毒感染的临床疗效及对免疫功能的影响,并主动监测药物不良反应(ADR)发生情况。方法回顾性分析2020年1月28日至6月17日270例新型冠状病毒感染患者临床资料,根据治疗药物分为LPV/r组、INF-α组和联合组,每组各90例。收集并比较所有患者一般资料;统计并分析所有患者临床症状好转时间、核酸转阴时间、肺部影像学检查;比较3组淋巴细胞计数、CD4^(+)T淋巴细胞计数、CD8^(+)T淋巴细胞计数;统计所有患者ADR主动监测结果。结果与LPV/r组和INF-α组比较,联合组患者退热时间、呼吸道症状缓解时间、核酸转阴时间均缩短,肺部影像学检查改善率升高,差异均有统计学意义(P<0.05)。3组患者治疗后淋巴细胞计数、CD4^(+)T淋巴细胞计数、CD8^(+)T淋巴细胞计数均高于治疗前,差异均有统计学意义(P<0.05);与LPV/r组和INF-α组比较,联合组患者淋巴细胞计数、CD4^(+)T淋巴细胞计数、CD8^(+)T淋巴细胞计数均升高,差异均有统计学意义(P<0.05)。经临床药师结合患者个体情况综合评估,3组患者肝功能异常、关联性评价、严重程度分级及出院转归比较,差异均无统计学意义(P>0.05);联合组患者肝功能异常人数多于INF-α组,差异有统计学意义(P<0.05);联合组患者肝功能异常人数与LPV/r组比较,差异无统计学意义(P>0.05)。LPV/r组、INF-α组和联合组ADR总发生率分别为32.22%、12.22%、37.78%,LPV/r组与联合组最常见的为累及消化系统,主要表现为腹泻、恶心和呕吐,其次为皮疹/瘙痒。与INF-α组比较,LPV/r组和联合组腹泻、消化系统不良反应总人数及ADR总人数均较多,差异均有统计学意义(P<0.05);LPV/r组与联合组各项ADR发生率比较,差异均无统计学意义(P>0.05)。结论LPV/r联合INF-α能明显提高单一用药治疗新型冠状病毒感染的疗效,尤其在缩短核酸转阴时间Objective To investigate the clinical efficacy and immune function of lopinavir/ritonavir(LPV/r)combined with interferon-α(INF-α)in the treatment of 2019-ncov infection,and to actively monitor the occurrence of adverse drug reactions(ADR).Methods The clinical data of 270 patients with 2019-ncov infection from January 28 to June 17,2020 were retrospectively analyzed.According to the treatment drugs,the patients were divided into LPV/r group,INF-αgroup and combination group,with 90 cases in each group.The general data of all patients were collected and compared.The improvement time of clinical symptoms,nucleic acid negative conversion time,and pulmonary imaging examination of all patients were counted and analyzed.The lymphocyte count,CD4^(+)T lymphocyte count and CD8^(+)T lymphocyte count were compared among the three groups.The results of active monitoring of ADR in all patients were counted.Results Compared with LPV/r group and INF-αgroup,the antipyrexia time,respiratory symptoms relief time and nucleic acid negative conversion time were shortened,and the improvement rate of pulmonary imaging examination was increased in combination group,and the differences were statistically significant(P<0.05).The lymphocyte count,CD4^(+)T lymphocyte count and CD8^(+)T lymphocyte count of the three groups after treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).Compared with the LPV/r group and the INF-αgroup,the lymphocyte count,CD4^(+)T lymphocyte count and CD8^(+)T lymphocyte count in the combined group were all increased,and the differences were statistically significant(P<0.05).After comprehensive evaluation by clinical pharmacists combined with patients′individual conditions,there was no statistically significant difference in the correlation evaluation,severity classification and discharge outcome of abnormal liver function among the three groups(P>0.05).The number of patients with abnormal liver function in the combined group was higher than that in the

关 键 词：新型冠状病毒感染 洛匹那韦/利托那韦 Α-干扰素 药物不良反应 临床疗效 免疫功能 

分 类 号：R563[医药卫生—呼吸系统]