摘要
目的探讨帕拉米韦与奥司他韦治疗流感病毒性肺炎临床疗效及对外周血T淋巴细胞亚群水平的影响。方法选取郑州大学附属郑州中心医院2017年10月-2019年10月130例流感病毒性肺炎患者,按照入院顺序进行编号,通过随机数字表法分为帕拉米韦组(n=65例)与奥司他韦组(n=65例),分别给予帕拉米韦与奥司他韦进行治疗,比较两组临床症状、血清炎性因子、T淋巴细胞亚群水平、肝肾功能指标变化以及不良反应发生情况。结果帕拉米韦组、奥司他韦组临床治疗有效率分别为90.77%、87.69%,差异无统计学意义;帕拉米韦组患者呼吸困难缓解时间、体温恢复正常时间、咳痰消失时间、咳嗽消失时间、肺部啰音消失时间、住院时间均短于奥司他韦组(P<0.05);帕拉米韦组治疗后C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于奥司他韦组(P<0.05);帕拉米韦组治疗后CD_(4)^(+)以及CD_(4)^(+)/CD_(8)^(+)水平高于奥司他韦组,CD_(8)^(+)水平低于奥司他韦组(P<0.05);两组不良反应发生率分别为15.38%、16.92%,差异无统计学意义。结论帕拉米韦与奥司他韦均可有效治疗流感病毒性肺炎,治疗安全性较高,与奥司他韦相比,帕拉米韦可缩短临床症状改善时间,在改善肺部炎症,调节免疫功能方面效果更优。
OBJECTIVE To explore the clinical curative effect of peramivir and oseltamivir on influenza viral pneumonia(IVP)and their influences on serum T lymphocyte subsets.METHODS A total of 130patients with IVP admitted in Zhengzhou Central Hospital Affiliated to Zhengzhou University were enrolled between Oct 2017and Oct 2019.They were numbered according to admission order and then divided into the peramivir group(n=65)and oseltamivir group(n=65)by random number table method.The changes in clinical symptoms,levels of serum inflammatory factors and T lymphocyte subsets,liver and renal function indexes,and adverse reactions were compared between the two groups.RESULTS There was no significant difference in response rate of clinical treatment between the peramivir group and oseltamivir group(90.77%vs 87.69%).The dyspnea relief time,returning to normal time of temperature,disappearance time of expectoration,cough and lung rales,and hospitalization time in the peramivir group were significantly shorter than those in the oseltamivir group(P<0.05).After treatment,levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the peramivir group were significantly lower than those in the oseltamivir group(P<0.05),levels of CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)were significantly higher than those in the oseltamivir group,and CD_(8)^(+)level was significantly lower than that in the oseltamivir group(P<0.05).There was no significant difference in incidence of adverse reactions between the peramivir group and oseltamivir group(15.38%vs 16.92%).CONCLUSION Use of peramivir and oseltamivir for treatment of IVP can be effective and high safety.Compared with oseltamivir,peramivir can help to shorten improvement time of clinical symptoms,and do better in cutting down on lung inflammation and regulating immune function.
作者
李振华
张华
陈建丽
张倩
谢林森
李晓童
LI Zhen-hua;ZHANG Hua;CHEN Jian-li;ZHANG Qian;XIE Lin-sen;LI Xiao-tong(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan 450007,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第24期3717-3721,共5页
Chinese Journal of Nosocomiology
基金
河南省医学科技攻关计划基金资助项目(2018020767)
作者简介
通讯作者:张华,E-mail:luckzhanghua@163.com;李振华(1984-),女,硕士,副主任医师,研究方向:肺部感染、慢性气道疾病及胸膜疾病
