2020 年第 8 期 第 15 卷

洛匹那韦/利托那韦治疗新型冠状病毒肺炎致高三酰甘油血症等不良反应的回顾性分析

A retrospective study of hypertriglyceridemia and other adverse drug reactions for corona virus disease-19 induced by lopinavir-ritonavir 

作者：查君敬1方长太1白兆青1黄利娟2石利平1程高翔1储贻苗1鲁杏1梅本刚1

英文作者：Zha Junjing1 Fang Changtai1 Bai Zhaoqing1 Huang Lijuan2 Shi Liping1 Cheng Gaoxiang1 Chu Yimiao1 Lu Xing1 Mei Bengang1 

单位：1安徽省安庆市立医院重症医学科246003；2安徽省安庆市立医院病案室246003

英文单位：1Department of Intensive Care Unit Anqing Municipal Hospital Anhui Province Anqing 246003 China; 2Medical Record Department Anqing Municipal Hospital Anhui Province Anqing 246003 China

关键词：新型冠状病毒肺炎；洛匹那韦/利托那韦；药品不良反应；高三酰甘油血症

英文关键词：Coronavirusdisease-19;Lopinavir-Ritonavir;Adversedrugreactions;Hypertriglyceridemia 

• 摘要：

• 目的 探讨新型冠状病毒肺炎(COVID-19)患者使用洛匹那韦/利托那韦而导致高三酰甘油血症等不良反应的临床特征及规律。方法 选取2020年1月23日至3月4日安徽省安庆市立医院收治的COVID-19患者83例，患者均使用洛匹那韦/利托那韦(200 mg/50 mg)每次2粒每日2次进行抗病毒治疗，收集患者临床资料。排除入院时已经高三酰甘油及实验室资料不完整的患者，共纳入64例患者，按入院治疗后患者血清三酰甘油是否升高分为高三酰甘油组(HTG组)和正常三酰甘油组（对照组），比较2组各项资料的差异，分析患者发生高三酰甘油血症的危险因素。结果 83例COVID-19患者中64例发生药品不良反应，发生率为77.1%，其中发生高三酰甘油血症54例(65.1%)。药品不良反应与药物关联性评价为可能。HTG组白细胞计数、中性粒细胞计数、γ谷氨酰转肽酶水平、乳酸脱氢酶水平、C反应蛋白水平均明显高于对照组(均P＜0.05)。Logistic回归分析结果显示，入院时γ谷氨酰转肽酶升高是患者发生高三酰甘油血症的危险因素(比值比=1.188，95%置信区间：1.023～1.379，P=0.024)。结论 洛匹那韦/利托那韦在COVID-19治疗过程中药品不良反应发生率较高，其安全性有待进一步评估。

• Objective To investigate the clinical characteristics and regularity of adverse reactions such as triglyceridemia caused by lopinavir/ritonavir in corona virus disease-19(COVID-19) patients. Methods From January 23 to March 4，2020 ，83 cases COVID-19 patients admitted to Anqing Municipal Hospital, Anhui Province were selected. All the patients were given lopinavie-ritonavir 200 mg/50 mg， twice a day. Patients with triglycerides and incomplete laboratory data at admission were excluded. A total of 64 patients were included. According to the serum triglyceride of the hospitalized patients, they were divided into triglyceride group (HTG group) and normal triglyceride group (control group). The differences between the two groups were compared and the risk factors for triglyceridemia were analyzed. Results There were 64 cases of COVID-19 patients with adverse drug reactions, the incidence rate was 77.1% (64/83), including 54 cases (65.1%) of hypertriglyceridemia. The leukocyte count, neutrophil count, γ-glutamyl transpeptidase level, lactate dehydrogenase level, and C-reactive protein level in the HTG group were significantly higher than those in the control group (all P<0.05).It is possible to evaluate the relationship between adverse drug reactions and drugs. Logistic regression analysis showed that the increase of γ-glutamyl transpeptidase was a risk factor for hypertriglyceridemia in patients upon admission (odds ratio=1.188, 95% confidence interval: 1.023-1.379, P=0.024). Conclusion Lopinavir / Ritonavir has a high incidence of adverse drug reactions during the treatment for COVID-19 and its safety needs to be further evaluated.