临床荟萃 ›› 2025, Vol. 40 ›› Issue (2): 147-152.doi: 10.3969/j.issn.1004-583X.2025.02.009

• 论著 • 上一篇    下一篇

新型冠状病毒感染应用不同抗病毒药物治疗后的疗效分析

吴万锋1,2a, 王云云2b, 杨道坤1()   

  1. 1.新乡医学院第一附属医院 感染性疾病科, 河南 新乡 453100
    2.晋城市人民医院 a.感染科; b.药学部, 山西 晋城 048000
  • 收稿日期:2024-12-04 出版日期:2025-02-20 发布日期:2025-03-05
  • 通讯作者: 杨道坤 E-mail:dk139496206692163.com

Comparative study on the clinical efficacy of different antiviral drugs in the treatment of COVID-19

Wu Wanfeng1,2a, Wang Yunyun2b, Yang Daokun1()   

  1. 1. Department of Infectious Diseases, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
    2. Department of Infection, b.Department of Pharmacy, Jincheng People's Hospital, Jincheng 048000, China
  • Received:2024-12-04 Online:2025-02-20 Published:2025-03-05
  • Contact: Yang Daokun E-mail:dk139496206692163.com

摘要:

目的 探究新型冠状病毒(Coronavirus Disease 2019,COVID-19)感染不同抗病毒药物治疗的临床疗效。方法 选取2023年2-6月期间晋城市人民医院收治的COVID-19患者456例,根据随机数字法分为A组(予以阿兹夫定,n=152)、B组(予以奈玛特韦/利托那韦,n=152)、C组(予以先诺特韦/利托那韦,n=152)。对比3组患者临床疗效、症状、体征恢复正常时间、病死率、肺部影像学、血常规[白细胞计数(white blood cell count,WBC)、中性粒细胞计数(absolute neutrophil count,ANC)、淋巴细胞计数(lymphocyte count,LYC)]变化、ORF1ab基因和N基因CT值以及不良反应发生情况。结果 3组临床疗效、各症状恢复正常时间、ORF1ab基因及N基因CT值、病死率、肺部影像学改善所需时间以及核酸转阴时间比较,差异无统计学意义(P>0.05)。用药后,3组WBC、ANC水平均降低,LYC水平均升高,但3组WBC、ANC、LYC水平比较差异无统计学意义(P>0.05)。A组不良反应总发生率为15.12%(23/152),B组为16.44%(25/152),C组为13.80%(21/152),3组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 阿兹夫定、奈玛特韦/利托那韦、先诺特韦/利托那韦在治疗COVID-19方面均具有显著的抗病毒效果,但存在一些不良反应以及用药限制,因此,临床使用以上药物时,应充分考虑患者的具体情况及用药风险,并严格遵循医嘱与用药指导,确保患者安全和疗效。

关键词: 新型冠状病毒感染, 抗病毒药, 治疗结果

Abstract:

Objective To explore the clinical efficacy of different antiviral drugs in the treatment of Coronavirus Disease 2019 (COVID-19). Methods A total of 456 COVID-19 patients admitted to Jincheng People's Hospital from February 2023 to June 2023 were selected for the study. According to the random number method, they were randomly divided into group A (treated with azvudine, n=152), group B (treated with nirmatrelvir/ritonavir, n=152) and group C (treated with simnotrelvir/ritonavir, n=152). The clinical efficacy, symptom and sign recovery time, mortality, lung imaging, complete blood count (white blood cell count [WBC], absolute neutrophil count [ANC], and lymphocyte count [LYC]), CT values (mRNA levels) of the ORF1ab and N genes, and adverse events were observed. Results There were no significant differences in the clinical efficacy, symptom and sign recovery time, CT values of the ORF1ab and N genes, mortality, time required for lung imaging improvement, and negative conversion time of nucleic acid testing among groups A, B and C (P>0.05). After treatment, WBC and ANC significantly decreased, and LYC significantly increased in all the three groups, although intergroup comparisons did not show significant differences (P>0.05). The total incidence of adverse events was 15.12%(23/152) in group A, 16.44%(25/152) in group B, and 13.80% (21/152) in group C. There was no significant difference in the total incidence of adverse events among groups A, B and C (P>0.05). Conclusion Azvudine, nirmatrelvir/ritonavir, and simnotrelvir/ritonavir have significant antiviral effects against COVID-19, although leading to some adverse events and medication restrictions. Therefore, when using the above drugs in clinical practice, the specific conditions and medication risks of patients should be fully considered, and a strict compliance and medication guidance are essential, aiming to ensure patient's safety and efficacy.

Key words: COVID-19, antiviral agents, treatment outcome

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