奥司他韦治疗病毒性肺炎患者的疗效及肺泡表面活性蛋白基因多态性的临床研究OA

Objective To explore the clinical efficacy and safety of oseltamivir granules in the treatment of patients with lung injury induced by viral pneumonia.Methods Adult patients with severe acute viral pneumonia admitted to our hospital were divided into control group and treatment group by the random number table method.All enrolled patients received basic symptomatic treatment.The control group was given ribavirin by intravenous infusion at a dose of 0.5 g twice daily for 7 days;the treatment group was administered oral oseltamivir phosphate granules at 75 mg twice daily for 5 days.The two groups were compared in terms of surfactant protein B(SP-B)gene polymorphism,lung injury markers and inflammatory factor levels,and safety evaluation was performed.Results A total of 128 patients were enrolled,with 64 cases in each group.Four patients dropped out from the control group,leaving 60 cases for final analysis in this group.After treatment,the total clinical effective rates of the control group and treatment group were 75.00％(45 cases/60 cases)and 92.19％(59 cases/64 cases),respectively,with statistically significant difference(P＜0.05).After treatment,the length of hospital stay was(13.25±2.46)days in the control group and(10.18±2.12)days in the treatment group;the duration of mechanical ventilation was(7.52±1.86)and(5.36±1.54)days,respectively;the levels of interleukin-1 β(IL-1 β)were(36.59±3.32)and(34.68±3.29)pg·mL-1;IL-6 were(55.40±3.05)and(52.68±2.89)ng·L-1;tumor necrosis factor-α(TNF-α)were(59.60±4.29)and(57.30±3.78)ng·L-1;Krebs von den Lungen-6(KL-6)were(499.12±70.22)and(470.28±67.14)U·mL-1;SP-D were(256.44±34.66)and(239.38±32.31)ng·mL-1;the proportion of wild-type genotype was 80.00％(48 cases/60 cases)and 62.50％(40 cases/64 cases),the frequency of wild-type allele was 91.67％(110 cases/120 cases)and 78.13％(100 cases/128 cases).All above indicators showed statistically significant differences between the treatment group and the control group(all P＜0.05).Pearson correlation analysis confirmed that SP-B gene polymorphism was positively correlated with IL-1 β,IL-6,TNF-α,high-sensitivity c-reactive protein(hs-CRP),KL-6 and SP-D in patients with viral pneumonia complicated with lung injury(all P＜0.05).Adverse drug reactions in the treatment group included nausea and vomiting,diarrhea and abdominal pain,dizziness and headache,insomnia,anemia,abnormal liver function and abnormal renal function.The total incidence of adverse drug reactions was 31.25％(20 cases/64 cases)in the treatment group and 26.67％(16 cases/60 cases)in the control group,without statistically significant difference(P＞0.05)