新型冠状病毒感染应用不同抗病毒药物治疗后的疗效分析  

Comparative study on the clinical efficacy of different antiviral drugs in the treatment of COVID-19

作　　者：吴万锋 王云云 杨道坤[1] Wu Wanfeng;Wang Yunyun;Yang Daokun(Department of Infectious Diseases,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China;Department of Infection,Jincheng People's Hospital,Jincheng 048000,China;Department of Pharmacy,Jincheng People's Hospital,Jincheng 048000,China)

机构地区：[1]新乡医学院第一附属医院感染性疾病科,河南新乡453100 [2]晋城市人民医院感染科,山西晋城048000 [3]晋城市人民医院药学部,山西晋城048000

出　　处：《临床荟萃》2025年第2期147-152,共6页Clinical Focus

摘　　要：目的探究新型冠状病毒(Coronavirus Disease 2019,COVID-19)感染不同抗病毒药物治疗的临床疗效。方法选取2023年2-6月期间晋城市人民医院收治的COVID-19患者456例,根据随机数字法分为A组(予以阿兹夫定,n=152)、B组(予以奈玛特韦/利托那韦,n=152)、C组(予以先诺特韦/利托那韦,n=152)。对比3组患者临床疗效、症状、体征恢复正常时间、病死率、肺部影像学、血常规[白细胞计数(white blood cell count,WBC)、中性粒细胞计数(absolute neutrophil count,ANC)、淋巴细胞计数(lymphocyte count,LYC)]变化、ORF1ab基因和N基因CT值以及不良反应发生情况。结果3组临床疗效、各症状恢复正常时间、ORF1ab基因及N基因CT值、病死率、肺部影像学改善所需时间以及核酸转阴时间比较,差异无统计学意义(P>0.05)。用药后,3组WBC、ANC水平均降低,LYC水平均升高,但3组WBC、ANC、LYC水平比较差异无统计学意义(P>0.05)。A组不良反应总发生率为15.12%(23/152),B组为16.44%(25/152),C组为13.80%(21/152),3组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论阿兹夫定、奈玛特韦/利托那韦、先诺特韦/利托那韦在治疗COVID-19方面均具有显著的抗病毒效果,但存在一些不良反应以及用药限制,因此,临床使用以上药物时,应充分考虑患者的具体情况及用药风险,并严格遵循医嘱与用药指导,确保患者安全和疗效。Objective To explore the clinical efficacy of different antiviral drugs in the treatment of Coronavirus Disease 2019(COVID-19).Methods A total of 456 COVID-19 patients admitted to Jincheng People's Hospital from February 2023 to June 2023 were selected for the study.According to the random number method,they were randomly divided into group A(treated with azvudine,n=152),group B(treated with nirmatrelvir/ritonavir,n=152)and group C(treated with simnotrelvir/ritonavir,n=152).The clinical efficacy,symptom and sign recovery time,mortality,lung imaging,complete blood count(white blood cell count[WBC],absolute neutrophil count[ANC],and lymphocyte count[LYC]),CT values(mRNA levels)of the ORF1ab and N genes,and adverse events were observed.Results There were no significant differences in the clinical efficacy,symptom and sign recovery time,CT values of the ORF1ab and N genes,mortality,time required for lung imaging improvement,and negative conversion time of nucleic acid testing among groups A,B and C(P>0.05).After treatment,WBC and ANC significantly decreased,and LYC significantly increased in all the three groups,although intergroup comparisons did not show significant differences(P>0.05).The total incidence of adverse events was 15.12%(23/152)in group A,16.44%(25/152)in group B,and 13.80%(21/152)in group C.There was no significant difference in the total incidence of adverse events among groups A,B and C(P>0.05).Conclusion Azvudine,nirmatrelvir/ritonavir,and simnotrelvir/ritonavir have significant antiviral effects against COVID-19,although leading to some adverse events and medication restrictions.Therefore,when using the above drugs in clinical practice,the specific conditions and medication risks of patients should be fully considered,and a strict compliance and medication guidance are essential,aiming to ensure patient's safety and efficacy.

关 键 词：新型冠状病毒感染 抗病毒药 治疗结果 

分 类 号：R563.12[医药卫生—呼吸系统]