洛匹那韦/利托那韦治疗新型冠状病毒肺炎致腹泻及防治分析

Analysis of diarrhea associated with lopinavirritonavir for COVID-19 and its prevention

目的探讨南充地区新型冠状病毒肺炎(COVID-19)患者使用洛匹那韦/利托那韦导致腹泻的特点及规律,为临床安全用药及防治提供参考依据。方法对南充市9家定点收治新型冠状病毒肺炎的医疗机构使用洛匹那韦/利托那韦治疗的患者资料进行回顾性分析,包括患者主要不良反应类型、严重程度、不同处理方法及预后的因素。结果截至2020年2月17日,南充市定点收治新型冠状病毒肺炎病例共35例,其中33例给予洛匹那韦/利托那韦(200mg/50mg)2粒BID抗病毒治疗,其余均对症支持治疗。药物使用过程中,发生腹泻15例,其中单纯腹泻11例、腹泻伴呕吐感3例、腹泻伴皮疹1例,腹泻不良反应的发生率达45.45%,经过治疗,14例治愈,1例续观。结论对症支持疗法是治疗新型冠状病毒肺炎的关键。当新型冠状病毒肺炎患者使用洛匹那韦/利托那韦出现恶心呕吐、腹泻等不良反应时,建议采取停药或对症处理等措施。

Objective To understand the characteristics and rules of adverse reactions of Corona Virus Disease 2019(COVID-19) in Nanchong area using lopinavir-ritonavir, so as to provide evidence for clinical medication safety and effectiveness. Methods COVID-19 cases in 9 hospitals in Nanchong were collected and investigated by retrospective analysis. The main adverse reaction types, different treatment methods, treatment measures and prognosis were collected and analyzed. Results As of February 17, 2020, 35 cases of COVID-19 in Nanchong were admitted. Among these, 33 cases were treated with the diagnostic protocol of COVID-19. Patients were given lopinavir-ritonavir 200 mg/50 mg BID for antiviral therapy. At the same time, other symptoms were treated with symptomatic support. In the course of drug use, 18 patients had different degrees of diarrhea, rash and other adverse drug reactions. There were 11 cases of diarrhea, 3 cases of diarrhea with vomiting, 1 case of diarrhea with rash. The incidence of diarrhea adverse reactions was 45.45%. Conclusion COVID-19 in the region has been explored and summarized for nearly a month, and symptomatic supportive therapy is the key of treating COVID-19. When COVID-19 patients used lopinavir-ritonavir appeared adverse reactions such as nausea, vomiting and diarrhea. It is recommended to take measures such as stopping or symptomatic treatment.