摘要
目的本研究旨在系统评价基于既往冠状病毒肺炎的研究,进而探索洛匹那韦/利托那韦(LPV/r)用于2019新型冠状病毒肺炎的临床可行性。方法在计算机检索中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库(Wangfang Data)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、EMBASE等数据库检索相关研究。此外,检索中文医药类报刊、WHO以及美国和中国CDC网站、已发表文献的相关参考文献等作为辅助。检索时间范围为2003年1月到2020年1月24日。研究纳入标准:研究纳入标准:(1)研究为比较洛匹那韦/利托那韦与安慰剂/标准治疗方案用于严重急性呼吸综合征(SARS)、中东综合征(MERS)患者;(2)临床结局进行评价临床队列研究和病例-对照研究;(3)诊断根据WHO公布的确诊或疑似SARS或MERS病例的诊断标准,但不排除流行初期诊断为感染的病例;(4)对同一研究多次发表的报告,我们从提供最详细信息的报告中提取资料;(5)指南性文件,包括:临床指南、国家级学会/团体的专家共识。排除标准:(1)仅有摘要无全文的文献资料以及数据不完整无法利用的文献;(2)离体细胞试验。两名评价员独立提取研究设计、对象及诊断标准、干预方案、结局(包括死亡、并发症、症状、生活质量、激素的使用、胸部影像及药物不良反应)等资料进行统计分析。结果通过文献检索,发现潜在相关文章230篇,初筛后获得44篇文章,最终纳入4个研究。结果提示LPV/r的药物方案的早期应用能够降低SARA患者病死率,减少糖皮质激素用量,对控制患者治疗后期并发症具有重要意义。结论LPV/r可以作为一种试验性疗法用于2019-nCoV肺炎(尤其是新发感染者)的抗病毒治疗,并应该为此尽快开展真实世界临床研究,进一步探索LPV/r早期用于2019-nCoV新型肺炎的临床效应。
Objective To explore the possibility of using Lopinave/Litonawe(LPV/r)as treatment for novel coronavirus 2019-nCov pneumonia by systematically review earlier coronavirus studies.Methods Systematically retrieve relevant clinical studies from Chinese and English databases such as CNKI,VIP,Wangfang Data,CBM,PubMed,Web of Science,EM BASE.In addition,information from Chinese biomedical journals,WHO,US CDC,Chinese CDC websites and the references from published relevant articles were retrieved.The inclusion period is from January 2003 to January 24,2020.The criteria for inclusion are:(1)studies that aim to compare LPV/r and placebo/standard for SARS,MERS;(2)studies that include at least one clinical outcome;(3)studies with diagnosis criteria meeting WHO requirement on SARS or MERS;(4)data from multiple reports but originated from one study,where we extract information from all reports;(5)guidelines,includes:national or academic guidelines/experts'consensus.The exclude criteria are:1)only have abstracts but no full information;2)in vitro studies.Two reviewers independently review articles and extract data on study design,patients,diagnosis criteria,regimen,and clinical outcomes(mortality,morbidity,quality of life,steroids dosage,chest image and adverse responses).Results Two hundred and thirty potential article were found by screening,and narrow down to forty-four articles for evaluation and finally four studies were included.The results of included studies indicate the early use of LPV/r regimen can reduce the mortality of SARS and MERS,and reduce steroids dosing.Conclusions ILPV/r can be used as a component of experimental regimen for treat novel coronavirus pneumonia.It strongly suggests that initiating real world studies to explore the true clinical effects of LPV/r on novel coronavirus pneumonia patients.
作者
江华
邓洪飞
王宇
刘展
孙明伟
周平
夏琪
Charles Damien Lu
曾俊
Jiang Hua;Deng Hongfei;Wang Yu;Liu Zhan;Sun Mingwei;Zhou Ping;Xia Qi;Charles Damien Lu;Zeng Jun(Institute for Emergency and Disaster Medicine,Sichuan Provincial People's Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072 China;Emergency Medical Center,Sichuan Provincial People's Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072 China;Emergency Intensive Care Unit,Sichuan Provincial People's Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072 China;Nursing Department,Sichuan Provincial People's Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072 China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2020年第2期183-187,共5页
Chinese Journal of Emergency Medicine
基金
国家卫健委急诊医学重点专科建设项目
四川省科技厅科技支撑计划项目及重点研究项目(2014FZ0125,2019YFS0534)。
