阿兹夫定治疗新型冠状病毒感染的疗效和安全性

Efficacy and safety of azvudine in the treatment of COVID-19

目的 观察阿兹夫定治疗新型冠状病毒感染患者的疗效和不良反应。方法 收集内江市第一人民医院2022年12月至2023年1月使用阿兹夫定足疗程(≥7 d)治疗新型冠状病毒感染的490例病例,并记录患者年龄、性别、并发症、给药时机,对比不同年龄段、不同性别、不同给药时机、不同重症高危因素(如心脑血管疾病、慢性肺部疾病、糖尿病等)患者的转归及不良反应情况。结果 18~59岁组住院日短于80岁以上组(P<0.05),好转率高于80岁以上组(P<0.01);无重症高危因素组住院日短于重症高危因素≥2个的组别(P<0.01),好转率高于重症高危因素≥2个的组别(P<0.01);1个重症高危因素组住院日短于重症高危因素≥3个的组别(P<0.05),两组好转率比较,差异无统计学意义(P>0.05);女性患者住院日短于男性(P<0.05),两者好转率比较,差异无统计学意义(P>0.05);出现症状5 d内给药组与出现症状5 d后给药组住院日比较差异无统计学意义(P>0.05),但出现症状5 d后给药组好转率更高(P<0.05)。490例患者用药后出现不良反应185例,主要有肝功能异常(91例)、肾功能异常(43例)、电解质异常(18例)等,总体发生率分别为18.57%、8.78%、3.67%;重症、肝肾功能、年龄等高危因素与患者不良反应发生率无显著相关性。结论 年龄、重症高危因素是影响新型冠状病毒感染好转率的重要因素;在使用阿兹夫定的过程中应加强监测肝肾功能、电解质等。

Objective To observe the therapeutic effect and adverse reactions of azvudine in the treatment of patients with COVID-19.Methods Totally 490 cases treated with a complete course(≥7 days)of azvudine for COVID-19 in the First People′s Hospital of Neijiang from December 2022 to January 2023 were collected.The age,gender,complications and timing of administration of the patients were recorded.The outcomes and adverse reactions of patients were compared among patients with different ages,genders,administration timings,and different severe high-risk factors(such as cardiovascular diseases,chronic pulmonary diseases,diabetes,etc.).Results The length of hospital stay in 18~59 year-old group was shorter than that in>80 year-old group(P<0.05),while the improvement rate was higher(P<0.01);the length of hospital stay in patients with at least 2 severe risk factors was longer than that in patients with no severe risk factor(P<0.01),while the improvement rate was lower(P<0.01);the length of hospital stay in patients with 1 severe risk factor was shorter than that in patients with at least 3 severe risk factors(P<0.05),but there was no significant difference in the improvement rate between them(P>0.05);the length of hospital stay in female patients was shorter than that in male patients(P<0.05),but there was no significant difference in the improvement rate between them(P>0.05);there was no significant difference in the length of hospital stay between the group with administration within 5 days of symptom onset and the one after 5 days(P>0.05),but the improvement rate in the group with administration after 5 days of symptom onset was higher(P<0.05).There were 185 cases of adverse reactions in 490 patients,including abnormal liver function(91 cases,18.57%),abnormal renal function(43 cases,8.78%)and abnormal electrolyte(18 cases,3.67%).There was no significant correlation between the incidence of adverse reactions and risk factors,such as severe type,liver and kidney function and age.Conclusion Age and severe high-risk factors are important factors that affect the improvement rate of patients with COVID-19.It is necessary to strengthen the monitoring of liver function,kidney function and electrolytes during azvudine treatment.