抗病毒治疗对新型冠状病毒肺炎患者肺部炎症吸收率的影响

Effect of antiviral therapy on absorption rate of lung inflammation of patients with COVID-19

目的探讨抗病毒治疗对新型冠状病毒肺炎(COVID-19)患者肺部炎症吸收率的影响。方法选择2020年1月-2020年2月于重庆市公共卫生医疗救治中心确诊COVID-19患者164例作为对象,根据时间点不同分为对照组(2020年1月-2020年1月末,n=82)和研究组(2020年2月-2020年2月末,n=82)。对照组采用对症支持干预,研究组在对照组基础上联合抗病毒治疗,14 d治疗后对患者效果进行评估,比较两组血气水平、降钙素原(PCT)、C-反应蛋白(CRP)、CD4、白细胞计数及感染率。结果研究组与对照组治疗后14 d pH水平无统计学意义;研究组治疗后14 d氧分压(PO2)、二氧化碳分压(PCO2)、吸入氧浓度(FiO2)、氧合指数(PO2/FiO2)水平均高于对照组(P<0.05);研究组治疗后14 d PCT、CRP、白细胞计数水平低于对照组(P<0.05);CD4水平高于对照组(P<0.05);两组治疗后7 d、14 d感染率无统计学差异;研究组治疗后1 d、3 d感染率、治疗后病死率低于对照组(P<0.05)。结论抗病毒治疗联合对症支持干预用于COVID-19患者中能改善患者血气水平,能促进肺部炎症吸收,降低治疗过程中感染率,值得推广应用。

OBJECTIVE To explore the effect of antiviral therapy on absorption rate of lung inflammation of patients with COVID-19. METHODS A total of 164 patients who were diagnosed with COVID-19 in Chongqing Public Health Medical Center from Jan 2020 to Feb 2020 were recruited as the study objects and divided into the control group with 82 cases( from Jan 2020 to the end of Jan, 2020) and the study group with 82 cases( from Feb 2020 to the end of Feb, 2020). The control group was given symptomatic support intervention, while the study group was given antiviral therapy on basis of the treatment of the control group. The curative effects of the patients were evaluated after the treatment for 14 days. The blood gas indexes, procalcitonin(PCT), C-reactive protein(CRP), CD4, white blood cell(WBC) counts and infection rate were compared between the two groups. RESULTS There was no significant difference in the pH level between the study group and the control group after the treatment for 14 days. The partial pressure of oxygen(PO2), partial pressure of carbon dioxide(PCO2), concentration of inhaled oxygen(FiO2) and oxygenation index(PO2/FiO2) of the study group were significantly higher than those of the control group after the treatment for 14 days(P<0.05). The levels of PCT, CRP and WBC of the study group were lower than those of the control group(P<0.05);the CD4 level of the study group was significantly higher than that of the control group(P<0.05). There was no significant difference in the infection rate between the two groups after the treatment for 7 and 14 days;the infection rates of the study group were significantly lower than those of the control group after the treatment for 1 and 3 days, and the mortality rate of the study group was significantly lower than that of the control group after the treatment(P<0.05). CONCLUSION The antiviral therapy combined with symptomatic support intervention can improve the levels of blood gas indexes of the patients with COVID-19, promote the absorption of inflammation in the lungs and reduce the infection rate during the treatment. It is worthy to be promoted.