洛匹那韦/利托那韦对新型冠状病毒肺炎确诊及疑似患者心率的影响

Effect of Lopinavir/Ritonavir on the Heart Rates of Confirmed and Suspected Patients with Coronavirus Disease 2019

目的促进洛匹那韦/利托那韦治疗新型冠状病毒肺炎(简称新冠肺炎)确诊及疑似患者的合理用药。方法选取湖南医药学院第一附属医院2020年1月15日至2月13日10例新冠肺炎确诊或疑似病例入院患者的临床资料,其中确诊7例,包括危重型1例、重型5例、普通型1例;社区获得性肺炎3例。均使用洛匹那韦/利托那韦抗病毒治疗,疗程5~7 d。观察患者入院时、用药后第1~5天、停药后第1~5天以及出院时静息状态下的心率。结果服药第1~5天,心率总体呈下降趋势,其中服药后第2~3天心率降幅较大;停药后,所有患者心率均呈缓慢上升趋势,并逐渐接近出院时的心率。结论洛匹那韦/利托那韦治疗病毒性肺炎尤其是新冠肺炎,可降低患者的心率。治疗过程中应警惕患者心率变化情况,必要时给予药物干预,以防发生严重心律失常。

Objective To promote the rational use of lopinavir/ritonavir in the treatment of confirmed and suspected patients with coronavirus disease 2019(COVID-19).Methods The clinical data of 10 confirmed or suspected patients with COVID-19 admitted to The First Affiliated Hospital of Hunan University of Medicine from January 15 th,2020 to February 13 th,2020 were collected.Among them,7 cases were confirmed with COVID-19,including 1 case of severe and critical type,5 cases of severe type,1 case of common type,the other 3 cases were confirmed with community-acquired pneumonia.All patients were treated with antiviral therapy of lopinavir/ritonavir for 5-7 d.The patients’heart rates at rest were observed at admission,1-5 d after administration,1-5 d after drug withdrawal and at discharge.Results From the first day to the fifth day of administration,the heart rates of all the patients generally decreased,among which the heart rates decreased significantly on the 2 nd day and the 3 rd day after taking the medicine.After drug withdrawal,the heart rates of all the patients increased slowly and gradually approached the heart rates at discharge.Conclusion Lopinavir/ritonavir in the treatment of patients with viral pneumonia(especially COVID-19)can reduce the heart rate.We should be alert to the changes in heart rates of patients during treatment and give drug intervention to prevent serious arrhythmias if necessary.