新型冠状病毒肺炎(COVID-19)治疗方案中α-干扰素使用的评价

Evaluation ofα-Interferon Applied in COVID-19 Therapy Regimen

目的新型冠状病毒肺炎(COVID-19)暴发引起广泛关注,国家卫生健康委员会诊疗方案中推荐α-干扰素(IFN-α)雾化吸入治疗,但目前尚无IFN-α的雾化吸入剂型,超说明书用药的可行性值得探讨。方法笔者回顾了SARS和MERS临床研究,据此讨论COVID-19治疗中IFN的有效性和安全性。通过雾化吸入特点、IFN-α的性质及其临床研究对IFN-α雾化吸入的可行性进行分析。结果IFN-α可缓解疾病的早期症状,但可能不显著影响危重患者死亡率,仍需开展更多随机对照临床研究;选择适宜的雾化装置及药液浓度后IFN-α的活性无明显变化,但由于缺乏必要的辅料,其体内吸收利用效果不佳,注射液中辅料成分有增加不良反应的风险。结论IFN-α注射液雾化吸入应充分评估风险,缺乏适宜雾化装置或操作人员时,可尝试性选择皮下注射的给药方式。

OBJECTIVE To use IFNαinjection as inhalant for there is no proper dosage form for aerosol inhalation and evaluate the feasibility of IFN-αoff-label use.METHODS The clinical studies in SARS and MERS were reviewed to discuss the efficacy and safety of IFN-αapplication in COVID-19.Meanwhile,the features of aerosol inhalation,characteristics of IFN-αand related clinical researches were analyzed to argue the possibility of IFN-αaerosol inhalation.RESULTS IFN-αseems to be effective in relieving early symptoms but likely invalid in reducing mortality of severe patients,however,the exact therapeutic effect calls for further clinical tests.Proper atomization of IFN-αinjection won't reduce biological activity of the protein,but absorption and utilization of IFN-αin lung may be unsatisfactory for the lack of sorbefacient.More than that,ingredients in IFN-αinjection may increase risk of adverse reaction.CONCLUSION The aerosol inhalation of IFN-αinjection should be fully evaluated on the side of patients.If there is a lack of proper atomization device or operation staff,subcutaneous injection of IFN-αmay be a tentative administration.