磷酸奥司他韦联合利巴韦林治疗甲型H1N1流感的临床疗效评价

Clinical Evaluation of Oseltamivir Phosphate Combined with Ribavirin in the Treatment of Influenza A(H1N1)

目的评价磷酸奥司他韦联合利巴韦林注射液治疗甲型H1N1流感的临床疗效。方法将该院2017年11月—2018年8月收治的130例甲型H1N1流感患者按随机对照原则分为对照组与观察组,对照组静脉滴注利巴韦林治疗,观察组在对照组治疗基础上口服磷酸奥司他韦,比较两组的患者退热时间、咳嗽消失时间、咽痛消失时间、头痛缓解时间、病毒核酸转阴率及临床疗效。结果观察组的总有效率为95.4%,显著高于对照组(81.5%),差异有统计学意义(χ~2=6.104,P=0.013),观察组治疗3、5 d后的病毒核酸转阴率(86.2%,100.0%)均显著高于对照组(66.2%,86.2%),差异有统计学意义(χ~21=7.159,P1=0.007;χ~22=9.669,P2=0.002);观察组患者的退热时间、咳嗽消失时间、咽痛消失时间、头痛缓解时间均较对照组显著减少[(7.2±2.1)d vs (4.1±1.6)d;(8.5±2.2)d vs (5.1±2.0)d;(8.4±2.5)d vs (4.6±2.2)d;(8.1±1.9)d vs (4.3±2.0)d],差异均有统计学意义(t=6.467,9.220,9.200,11.106;P=0.000)。结论奥司他韦联合利巴韦林治疗甲型H1N1流感的临床疗效满意,与单独应用利巴韦林相比,可显著缩短临床症状缓解时间,提高病毒核酸转阴率。

Objective To evaluate the clinical efficacy of oseltamivir phosphate combined with ribavirin injection in the treatment of influenza A(H1N1).Methods 130 patients with influenza A(H1N1)admitted to our hospital from November 2018 to August 2017 were randomly divided into the control group and the observation group.The control group was treated with intravenous infusion of ribavirin.The observation group was in the control group.On the basis of treatment,oral oseltamivir phosphate was compared,and the antipyretic time,disappearance time of cough,time of disappearance of sore throat,time of headache relief,viral nucleic acid negative rate and clinical efficacy were compared between the two groups.Results The total effective rate of the observation group was 95.4%,which was significantly higher than that of the control group(81.5%).The difference was statistically significant(χ^2=6.104,P=0.013).The virus nucleic acid conversion rate after 3 d and 5 d treatment in the observation group(86.2%,100.0%)were significantly higher than the control group(66.2%,86.2%),the difference was statistically significant(χ^2 1=7.159,P1=0.007;χ^2 2=9.669,P2=0.002);the antipyretic time of the observation group patients The time of disappearance of cough,the time of disappearance of sore throat,and the time of headache relief were significantly lower than that of the control group [(7.2±2.1)d vs(4.1±1.6)d;(8.5±2.2)d vs(5.1±2.0)d;(8.4±2.5)d vs(4.6±2.2)d;(8.1±1.9)d vs(4.3±2.0)d],the difference was statistically significant(t=6.467,9.220,9.200,11.106;P=0.000).Conclusion The clinical efficacy of oseltamivir combined with ribavirin in the treatment of influenza A(H1N1)is satisfactory.Compared with ribavirin alone,it can significantly shorten the time of clinical symptom relief and increase the rate of viral nucleic acid conversion.