Tomono Noriaki, Shiro Hiroyuki
Yokohama Rosai Hospital.
Kansenshogaku Zasshi. 2008 Nov;82(6):613-8. doi: 10.11150/kansenshogakuzasshi1970.82.613.
Oseltamivir is a neuraminidase inhibitor preventing the release of the infectious influenza virus particles from the infected respiratory tract cells of the patients. It is known that the medicine reduces the duration and the severity of this infectious disease and the incidence of pneumonia as its complication. Recently some reports emerged mainly from Japan that neuropsyciatric events are provoked by oseltamivir. However, the neuraminidase inhibitor might be expected to prevent the events, as it reduces the viral burden. Therefore it was investigated whether oseltamivir reduces the incidence of the events.
The study was conducted at the Yokohama Rosai Hospital, Kanagawa, Japan since December 2006 to March 2007. Patients with fever who had got the positive result of the influenza viral antigen test but no neuropsyciatric events, older than one year old, were enrolled in this study. The cases were the patients who visited the outpatient department of the hospital for their neuropsychiatric events (Case Group). The controls were the patients more than one year old with no neuropsychiatric events (Control Group). Nasopharyngeal aspirate fluid was used for detecting influenza virus by using a rapid diagnosis test, the ESPLINE Influenza A&B-N (Fujirebio Corp., Japan). The proportion of gender, age, and the use of oseltamivir were compared in the two groups with t-test and chi-squared test.
Twelve cases and 335 control patients were enrolled in this study. The mean age and its standard deviation of the Case Group was 8.25 +/- 3.22 years old, which was significantly higher than that of the Control Group (6.09 +/- 3.74 years old, p = 0.049). The Case Group consisted with 9 boys (75.0%) and 3 girls (25.0%), as the Control Group had 183 boys (54.6%) and 152 girls (45.4%). The frequency of the type A virus was not significantly higher in the Case Group (7 patients, 58.3%) than in the Control Group (168 patients, 50.1%) (p = 0.162). Six cases (50.0%) in the Case Group had taken oseltamivir prior to the neuropsychiatric events on the contrast that 261 patients (77.9%) in the Control Group were prescribed the same medicine; the difference was statistically significant (p = 0.024).
It is concluded that oseltamivir, an influenza virus neuraminidase inhibitor, significantly reduces the incidence of the neuropsychiatric events of the patients with influenza virus infection.
奥司他韦是一种神经氨酸酶抑制剂，可阻止感染性流感病毒颗粒从患者受感染的呼吸道细胞中释放。已知该药物可缩短这种传染病的病程和严重程度，并降低其并发症肺炎的发生率。最近，主要来自日本的一些报告称，奥司他韦会引发神经精神事件。然而，由于神经氨酸酶抑制剂可减轻病毒载量，因此有望预防这些事件。因此，研究了奥司他韦是否能降低这些事件的发生率。
该研究于2006年12月至2007年3月在日本神奈川县横滨罗萨医院进行。纳入本研究的患者为年龄大于1岁、流感病毒抗原检测呈阳性但无神经精神事件的发热患者。病例组为因神经精神事件到医院门诊就诊的患者。对照组为年龄大于1岁且无神经精神事件的患者。采用快速诊断试验ESPLINE Influenza A&B-N（日本富士瑞必欧公司），用鼻咽抽吸液检测流感病毒。两组患者的性别、年龄及奥司他韦使用情况的比例采用t检验和卡方检验进行比较。
本研究共纳入12例病例和335例对照患者。病例组的平均年龄及其标准差为8.25±3.22岁，显著高于对照组（6.09±3.74岁，p = 0.049）。病例组有9名男孩（75.0%）和3名女孩（25.0%），对照组有183名男孩（54.6%）和152名女孩（45.4%）。病例组甲型病毒的检出频率（7例，58.3%）并不显著高于对照组（168例，50.1%）（p = 0.162）。病例组中有6例（50.0%）在发生神经精神事件前服用了奥司他韦，相比之下，对照组有261例患者（77.9%）服用了相同药物；差异具有统计学意义（p = 0.024）。
得出结论，流感病毒神经氨酸酶抑制剂奥司他韦可显著降低流感病毒感染患者神经精神事件的发生率。
