四种抗新型冠状病毒药物对肝功能影响的临床观察  

Clinical observation on the effects of four anti-novel coronavirus drugs on liver function

作　　者：张波[1] 李显东 ZHANG Bo;LI Xian-dong(Department of Emergency,Jilin Provincial People's Hospital,Changchun 130021,China)

机构地区：[1]吉林省人民医院急诊内科,130021 [2]长春市公安局朝阳分局刑事科学技术室,130021

出　　处：《中国实用医药》2024年第21期121-125,共5页China Practical Medicine

摘　　要：目的 观察阿兹夫定、奈玛特韦、莫诺拉韦、先诺特韦对新型冠状病毒感染患者肝功能的影响。方法 回顾性收集196例应用口服小分子抗病毒药物的新型冠状病毒感染患者的临床资料,根据所用药物不同将患者分为阿兹夫定组(92例)、奈玛特韦组(41例)、莫诺拉韦组(42例)、先诺特韦组(21例)。阿兹夫定组接受阿兹夫定治疗,奈玛特韦组接受奈玛特韦/利托那韦治疗,莫诺拉韦组接受莫诺拉韦治疗,先诺特韦组接受先诺特韦/利托那韦治疗。比较四组患者治疗前后肝功能指标水平,分析四组患者治疗后肝功能异常例数及占比,分析四组治疗后肝功能异常患者年龄及基础疾病。结果 阿兹夫定组治疗7 d后的谷丙转氨酶(47.24±13.86)U/L、谷草转氨酶(48.59±16.71)U/L高于治疗前的(38.87±19.14)、(40.18±22.33)U/L(P<0.05),碱性磷酸酶、总胆红素、直接胆红素与治疗前比较,无统计学差异(P>0.05)。奈玛特韦组治疗5 d后的谷丙转氨酶(61.71±27.74)U/L高于治疗前的(44.95±20.55)U/L(P<0.05),谷草转氨酶、碱性磷酸酶、总胆红素、直接胆红素与治疗前比较,无统计学差异(P>0.05)。莫诺拉韦组、先诺特韦组治疗5 d后的谷丙转氨酶、谷草转氨酶、碱性磷酸酶、总胆红素、直接胆红素与治疗前比较,均无统计学差异(P>0.05)。阿兹夫定组谷丙转氨酶、谷草转氨酶、碱性磷酸酶、总胆红素、直接胆红素异常分别为28例(30.4%)、9例(9.8%)、4例(4.3%)、0、4例(4.3%)。莫诺拉韦组谷丙转氨酶、谷草转氨酶、碱性磷酸酶、总胆红素、直接胆红素异常分别为7例(16.7%)、7例(16.7%)、1例(2.4%)、1例(2.4%)、1例(2.4%)。奈玛特韦组谷丙转氨酶、谷草转氨酶、碱性磷酸酶、总胆红素、直接胆红素异常分别为14例(34.1%)、11例(26.8%)、5例(12.2%)、1例(2.4%)、1例(2.4%)。先诺特韦组谷丙转氨酶、谷草转氨酶、碱性磷酸酶、总胆红素、直接胆红素异常�Objective To observe the effects of azvudine,nirmatrelvir,molnupiravir and simnotrelvir on liver function in patients with novel coronavirus infection.Methods Clinical data of 196 patients with novel coronavirus infection applying oral small molecule antiviral drugs were retrospectively collected,and the patients were categorized into the azivudine group(92 patients),the nirmatrelvir group(41 patients),the molnupiravir group(42 patients),and the simnotrelvir group(21 patients)according to the different drugs used.The azivudine group received azivudine treatment,the nirmatrelvir group received nirmatrelvir/ritonavir treatment,the molnupiravir group received molnupiravir treatment,and the simnotrelvir group received simnotrelvir/ritonavir treatment.The level of liver function indicators before and after treatment in the four groups was compared,the number and percentage of patients with abnormal liver function after treatment in the four groups were analyzed,and the age and underlying diseases of patients with abnormal liver function in the four groups were analyzed.Results In the azivudine group,the alanine aminotrasferase of(47.24±13.86)U/L and aspartate transaminase of(48.59±16.71)U/L after 7 d of treatment were higher than(38.87±19.14)and(40.18±22.33)U/L before treatment(P<0.05),and there was no statistically significant difference in the alkaline phosphatase,total bilirubin,and direct bilirubin when compared with those before treatment(P>0.05).In nirmatrelvir group,the alanine aminotransferase of(61.71±27.74)U/L after 5 d of treatment was higher than(44.95±20.55)U/L before treatment(P<0.05),and there was no statistically significant difference in the alanine aminotransferase,alkaline phosphatase,total bilirubin,and direct bilirubin when compared with those before treatment(P>0.05).In the molnupiravir group and simnotrelvir group,there was no statistical difference in alanine aminotrasferase,aspartate transaminase,alkaline phosphatase,total bilirubin,and direct bilirubin after 5 d of treatment when compar

关 键 词：新型冠状病毒感染 抗病毒药物 肝功能 

分 类 号：R978.7[医药卫生—药品]