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一项关于奥司他韦治疗高危人群流感疗效及安全性的多中心随机对照研究

[A multicenter randomized controlled study of the efficacy and safety of oseltamivir in the treatment of influenza in a high risk population].

作者信息

Lin Jiang-tao, Yu Xue-zhong, Cui De-jian, Chen Xu-yan, Zhu Ji-hong, Wang Yu-zhen, Wu Xiao-di, Gao He, Huo Zheng-lu, Zhu Shun-he, Hu Shan-lian, Wang Ai-xia

机构信息

Department of Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2004 Jul;27(7):455-9.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of oseltamivir in the treatment of influenza in a high risk population.

METHODS

A randomized, open, control trial was conducted from Nov. 2002 to Feb. 2003. Patients with chronic respiratory disease, such as chronic bronchitis, obstructive emphysema, bronchial asthma, bronchiectasis or chronic cardiac disease, and with symptoms of influenza were enrolled. They should satisfy the following criteria: Fever > or = 37.8 degrees C plus at least two of the following influenza symptoms: coryza/nasal congestion, sore throat, cough, myalgia/muscle aches and pain, fatigue, headache and chills/sweats. Within 48 h after the onset of the symptoms, the patients were randomly assigned to oseltamivir group (oseltamivir 75 mg, twice daily for 5 days) or control group (symptom relief medicine only).

RESULTS

Fifty-six of the 108 recruited patients were identified as influenza-infected through laboratory test. They were defined as intent-to-treat infected population (ITTI) (27 oseltamivir, 29 control). The duration of influenza symptom was 64 h shorter (36.7%) and AUC score of the influenza symptom was decreased by 618 (43.1%) in the oseltamivir group as compared with those in the control group. The fever duration was 46.8 h (45.0%) less in the oseltamivir group than that in the control group. It took 6 d for the oseltamivir group and 11 days for the control group to recover to the basic health status. Secondary complications such as bronchitis, sinusitis and pneumonia occurred 11% (3/27) in the oseltamivir group and 45% (13/29) in the control group. The treatment expense for influenza and its complication was 587.4 RMB in the oseltamivir group and 786.5 RMB in the control group, which showed no significant difference (P = 0.246).

CONCLUSIONS

It is suggested that oseltamivir is effective and well tolerated in patients with chronic respiratory or cardiac diseases. It can reduce the fever duration and severity of influenza symptom, and decrease the incidence of secondary complications and antibiotic use, while does not increase the total medical cost.

摘要

目的

评估奥司他韦治疗高危人群流感的疗效和安全性。

方法

于2002年11月至2003年2月进行了一项随机、开放、对照试验。纳入患有慢性呼吸系统疾病(如慢性支气管炎、阻塞性肺气肿、支气管哮喘、支气管扩张症)或慢性心脏病且有流感症状的患者。他们应满足以下标准:体温≥37.8℃,加上至少以下两种流感症状:流涕/鼻塞、咽痛、咳嗽、肌痛/肌肉酸痛、乏力、头痛及寒战/出汗。症状出现后48小时内,将患者随机分为奥司他韦组(奥司他韦75毫克,每日两次,共5天)或对照组(仅使用对症缓解药物)。

结果

108例招募患者中,56例经实验室检测确诊为流感感染。他们被定义为意向性治疗感染人群(ITTI)(27例奥司他韦组,29例对照组)。与对照组相比,奥司他韦组流感症状持续时间缩短64小时(36.7%),流感症状AUC评分降低618(43.1%)。奥司他韦组发热持续时间比对照组少46.8小时(45.0%)。奥司他韦组恢复至基本健康状态需6天,对照组需11天。奥司他韦组支气管炎、鼻窦炎和肺炎等次要并发症发生率为11%(3/27),对照组为45%(13/29)。奥司他韦组流感及其并发症的治疗费用为587.4元,对照组为786.5元,差异无统计学意义(P = 0.246)。

结论

提示奥司他韦对慢性呼吸系统或心脏病患者有效且耐受性良好。它可缩短发热持续时间,减轻流感症状严重程度,降低次要并发症发生率和抗生素使用,且不增加总医疗费用。

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