川东北地区洛匹那韦/利托那韦治疗新型冠状病毒肺炎不良反应分析

Adverse Drug Reactions Induced by Lopinavir/Ritonavir in the Treatment of the Coronavirus Disease 2019 in Northeast Sichuan

目的探讨川东北地区使用洛匹那韦/利托那韦治疗新型冠状病毒肺炎(简称新冠肺炎)所致药品不良反应(ADR)的规律及特点,为临床安全、有效用药提供参考。方法收集川东北地区确诊新冠肺炎患者的病历资料,采用回顾性分析法对洛匹那韦/利托那韦所致ADR的临床表现、处理措施及预后进行分析。结果截至2020年2月22日,南充、广安、巴中3个地区累计收治确诊患者92例,其中84例使用了洛匹那韦/利托那韦治疗,各地区患者ADR发生率分别为52.94%,58.62%,66.67%,无明显差异(P>0.05);ADR临床表现主要为腹泻、恶心、皮疹等,其中腹泻、恶心的发生率与治疗获得性免疫缺陷病毒(HIV)感染的发生率差异显著(P<0.05)。结论川东北地区应用洛匹那韦/利托那韦治疗新冠肺炎的ADR发生率均较高,其中腹泻、恶心的发生率及总ADR发生率在不同疾病间的差异显著。洛匹那韦/利托那韦用于治疗新冠肺炎的安全性和有效性有待进一步确认,临床用药需谨慎。

Objective To investigate the regularity and characteristics of adverse drug reactions(ADRs)induced by lopinavir/ritonavir in the treatment of the coronavirus disease 2019(COVID-19)in northeast Sichuan,and to provide reference for the safe and effective use of drugs in the clinic.Methods Medical records of patients diagnosed with COVID-19 in northeast Sichuan were collected,and the clinical manifestations,treatment measures and prognosis of ADRs induced by lopinavir/litonavir were analyzed retrospectively.Results As of February 22nd,2020,a total of 92 diagnosed patients with COVID-19 had been admitted to hospitals in Nanchong,Guang'an and Bazhong regions,among which 84 cases were treated with lopinavir/litonavir,the incidence rates of ADRs in the three regions were 52.94%,58.62%and 66.67%,respectively,but there was no significant difference in ADRs among the three regions(P>0.05).The main clinical manifestations of ADRs were diarrhea,nausea and rash,among which the incidence of diarrhea and nausea induced by lopinavir/ritonavir in the treatment of the COVID-19 and HIV infection was statistically significant(P<0.05).Conclusion The incidence of ADRs induced by lopinavir/ritonavir in the treatment of patients with COVID-19 in northeast Sichuan is relatively high,among which the incidence of diarrhea,nausea and total ADRs were significantly different among different diseases.The safety and efficacy of lopinavir/ritonavir in the treatment of the COVID-19 need to be further confirmed,and clinical medication should be cautious.