与奥司他韦单药治疗相比，奥司他韦-帕拉米韦联合治疗对甲型H7N9流感感染的疗效：一项回顾性研究。
Efficacy of oseltamivir-peramivir combination therapy compared to oseltamivir monotherapy for Influenza A (H7N9) infection: a retrospective study.
作者信息
Zhang Yan, Gao Hainv, Liang Weifeng, Tang Lingling, Yang Yida, Wu Xiaoxin, Yu Liang, Chen Ping, Zheng Shufa, Ou Huilin, Li Lanjuan
机构信息
The State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, HangZhou, China.
出版信息
BMC Infect Dis. 2016 Feb 10;16:76. doi: 10.1186/s12879-016-1383-8.
BACKGROUND
Since the novel H7N9 avian influenza outbreak occurred in China in 2013, neuraminidase inhibitors (NAIs) such as oseltamivir and peramivir have been used as first-line drugs to treat the influenza virus infection. This study aimed to compare the efficacy of oseltamivir-peramivir combination therapy versus oseltamivir monotherapy.
METHODS
A retrospective study of 82 H7N9 confirmed patients was conducted by reviewing medical charts at the First Affiliated Hospital of ZheJiang University in China from April 1, 2013 to Feb 28, 2014. The patients' clinical information was collected systematically, and we compared the virology and clinical data between oseltamivir monotherapy group (43 patients) and oseltamivir-peramivir combination group (39 patients).
RESULTS
The median duration from NAIs administration to H7N9 virus-negative in oseltamivir monotherapy group and oseltamivir-peramivir combination group was 6.50 and 7.00 days (p >0.05), respectively. The median decline of Day 2 to Day 0 (initiation of NAIs therapy) viral load was 0.00 and 0.69 log10 copies/μl (p >0.05) respectively in the monotherapy vs. combination therapy groups. The incidence of new Acute Respiratory Distress Syndrome during NAI administration was 63.89 and 77.78 % (p >0.05); while the mortality rates were 25.58 and 43.59 % (p >0.05) in the oseltamivir group vs. oseltamivir-peramivir group.
CONCLUSIONS
Our results suggest that in adults with H7N9 virus infection, the use of oseltamivir-peramivir combination therapy was not superior to oseltamivir monotherapy.
背景
自2013年中国出现新型H7N9禽流感疫情以来，奥司他韦和帕拉米韦等神经氨酸酶抑制剂（NAIs）一直被用作治疗流感病毒感染的一线药物。本研究旨在比较奥司他韦 - 帕拉米韦联合治疗与奥司他韦单药治疗的疗效。
方法
通过回顾中国浙江大学第一附属医院2013年4月1日至2014年2月28日期间的病历，对82例确诊为H7N9的患者进行了一项回顾性研究。系统收集患者的临床信息，并比较奥司他韦单药治疗组（43例患者）和奥司他韦 - 帕拉米韦联合治疗组（39例患者）之间的病毒学和临床数据。
结果
奥司他韦单药治疗组和奥司他韦 - 帕拉米韦联合治疗组从开始使用NAIs到H7N9病毒检测呈阴性的中位持续时间分别为6.50天和7.00天（p>0.05）。单药治疗组与联合治疗组中，第2天至第0天（开始NAIs治疗）病毒载量的中位下降值分别为0.00和0.69 log10拷贝/μl（p>0.05）。在使用NAIs期间，新发性急性呼吸窘迫综合征的发生率分别为63.89%和77.78%（p>0.05）；而奥司他韦组与奥司他韦 - 帕拉米韦组的死亡率分别为25.58%和43.59%（p>0.05）。
结论
我们的结果表明，在成人H7N9病毒感染患者中，使用奥司他韦 - 帕拉米韦联合治疗并不优于奥司他韦单药治疗。
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