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全球公共卫生突发事件新型冠状病毒肺炎(简称新冠肺炎,COVID-19),从2019年12月发生以来,截至2020年10月下旬,已造成全球3000多万人感染,100多万人死亡。抑制病毒复制是控制COVID-19发展的关键环节。由中国药学会医院药学专业委员会编写的《新型冠状病毒肺炎临床合理用药专家共识》[1],将COVID-19临床救治用药分为9类,第一类就是抗病毒药。《共识》指出,可试用的抗病毒药物有氯喹、羟氯喹、法匹拉韦、干扰素、利巴韦林、洛匹那韦/利托那韦、阿比多尔、瑞德西韦。口服抗病毒药原则上倾向于早期用、单独用,不主张3种及以上抗病毒药物合用,不建议使用神经氨酸酶抑制剂(如奥司他韦等)和更昔洛韦。
笔者所在的某新组建的救治COVID-19患者医院,共收治COVID-19确诊病人1765人,其中治愈出院1705例,转院27例,病死33例。本文就该院收治COVID-19患者所用抗病毒药物进行统计分析。
Analysis of the use for antiviral drugs in the treatment of COVID-19 patients in a Hubei hospital in 2020
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摘要:
目的 回顾性分析湖北省某医院救治1765名新冠肺炎患者的抗病毒药物使用情况,为临床合理用药提供经验和建议。 方法 依据国家卫健委《新型冠状病毒肺炎诊疗方案》推荐用药,对湖北省某医院在2020年2—4月救治新冠肺炎患者期间的抗病毒用药进行分析。 结果 收治的1765名患者中,1114名患者使用了抗病毒药物,占63.11%;使用率排名前3位的抗病毒药物分别为阿比多尔981例(55.58%)、干扰素α-2b 340例(19.26%)和氯喹72例(4.08%),排名前3的药物占所有抗病毒药物的80.61%;在治疗方案上,单用阿比多尔的636例,占57.09%,单用干扰素α-2b的98例,占8.8%,阿比多尔联合干扰素α-2b的164例,占14.72%;干扰素α-2b、阿比多尔、氯喹均存在超过20%的超疗程用药;6例病人抗病毒用药超过3种,50例病人使用了未被诊疗方案(第八版)推荐的羟氯喹。 结论 该院治疗新冠肺炎患者的抗病毒治疗用药,基本上是在国家卫健委同时段不断更新的《新型冠状病毒肺炎诊疗方案》指导下合理使用。 Abstract:Objective To retrospectively analyze the use of antiviral drugs in 1765 patients admitted to a hospital of COVID-19 in Hubei Province, and to provide experience and suggestions for clinical rational drug use. Methods The antiviral drugs used in a hospital in Hubei Province during the treatment of COVID-19 patients from February to April 2020 were analyzed according to the "New Coronary Virus Pneumonia Diagnosis and Treatment Program" recommendated by the National Health Commission. Results Among the 1765 patients, 1114 (63.11%) were treated with antiviral drugs. The top three antiviral drugs were arbidol (981 cases, use rate 55.58%), IFN-α-2b (340 cases, use rate 19.26%) and chloroquine (72 cases, use rate 4.08%) . Among all the antiviral regimens, 636 (57.09%) were treated with arbidol alone, followed by arbidol combined IFN-α-2b 164 (14.72%) , arbidol combined IFN-α-2b 98 (8.8%) , and the top three regimens accounted for 80.61% of all antiviral regimens. According to the COVID-19, IFN-α-2b, Arbidol, and chloroquine had more than 20% of the over-treatment duration, 6 patients used more than 3 antiviral drugs, and 50 patients had not been recommended for hydroxychloroquine. Conclusion The antiviral drugs used for the treatment of patients with COVID-19 in this hospital are basically used rationally under the guidance of the "New Coronary Virus Pneumonia Diagnosis and Treatment Program" continuously updated by the National Health Commission at the same time.. -
Key words:
- COVID-19 /
- antiviral drugs /
- drug utilization review /
- pharmaceutical care
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