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静脉注射帕拉米韦与奥司他韦治疗重症甲型流感合并原发性病毒性肺炎患者的临床疗效:一项随机对照研究

Clinical Effectiveness of Intravenous Peramivir Compared With Oseltamivir in Patients With Severe Influenza A With Primary Viral Pneumonia: A Randomized Controlled Study.

作者信息

Chen Hong-Dou, Wang Xu, Yu Shu-Le, Ding Yue-Hui, Wang Meng-Lei, Wang Jin-Na

机构信息

Suqian People's Hospital of Nanjing Drum-Tower Hospital Group, Suqian, China.

The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China.

出版信息

Open Forum Infect Dis. 2020 Nov 18;8(1):ofaa562. doi: 10.1093/ofid/ofaa562. eCollection 2021 Jan.

Abstract

BACKGROUND

High-quality evidence confirms that the clinical efficacy of peramivir in severe influenza patients with primary viral pneumonia is lacking. To optimize clinical medication, we evaluate the different efficacy between peramivir and oseltamivir in the treatment of severe influenza A with primary viral pneumonia.

METHODS

A single-center, randomized, controlled trial was conducted during the Chinese influenza season from December 2018 to April 2019 in patients with severe influenza A with primary viral pneumonia. A total of 40 inpatients were enrolled and treated with either intravenous peramivir (300 mg, once daily for 5 days) or oral oseltamivir (75 mg, twice daily for 5 days).

RESULTS

The duration of influenza virus nucleic acid positivity in the oseltamivir group and the peramivir group was 2.95 days and 2.80 days, respectively. The remission times of clinical symptoms in the oseltamivir group and the peramivir group were 3.90 days and 3.25 days, respectively. In addition, the remission time of cough symptoms in the peramivir group (63.89 hours) was shorter than that in the oseltamivir group (75.53 hours). There was no significant difference between these values ( > .05). The remission time of fever symptoms in the oseltamivir group was 23.67 hours, which was significantly longer than that in the peramivir group (12.32 hours) ( = .034).

CONCLUSIONS

Peramivir is no less effective than oseltamivir in the treatment of severe influenza A with primary viral pneumonia, and patients treated with peramivir had significantly shorter remission times of fever symptoms than those treated with oseltamivir.

摘要

背景

高质量证据证实,帕拉米韦在患有原发性病毒性肺炎的重症流感患者中的临床疗效欠佳。为优化临床用药,我们评估了帕拉米韦与奥司他韦在治疗伴有原发性病毒性肺炎的重症甲型流感中的不同疗效。

方法

于2018年12月至2019年4月中国流感季节期间,在患有原发性病毒性肺炎的重症甲型流感患者中开展了一项单中心、随机、对照试验。共纳入40例住院患者,分别接受静脉注射帕拉米韦(300mg,每日1次,共5天)或口服奥司他韦(75mg,每日2次,共5天)治疗。

结果

奥司他韦组和帕拉米韦组流感病毒核酸阳性持续时间分别为2.95天和2.80天。奥司他韦组和帕拉米韦组临床症状缓解时间分别为3.90天和3.25天。此外,帕拉米韦组咳嗽症状缓解时间(63.89小时)短于奥司他韦组(75.53小时)。这些数值之间无显著差异(>0.05)。奥司他韦组发热症状缓解时间为23.67小时,显著长于帕拉米韦组(12.32小时)(=0.034)。

结论

在治疗伴有原发性病毒性肺炎的重症甲型流感方面,帕拉米韦的疗效不低于奥司他韦,且接受帕拉米韦治疗的患者发热症状缓解时间显著短于接受奥司他韦治疗的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63b0/7793458/42c1df726dad/ofaa562_fig1.jpg

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