NEJM:青蒿琥酯-阿莫地喹联合治疗可能降低埃博拉病毒感染死亡风险

2016-01-07 MedSci MedSci原创

在西非,对于疑似埃博拉病毒感染(EVD)患者都应推荐进行抗疟治疗。佛牙埃博拉病毒感染治疗中心,蒿甲醚–本芴醇(抗疟治疗的一线药物组合)的供应在2014年8月已消耗完12天。这段时间内,患者接受青蒿琥酯-阿莫地喹联合治疗;阿莫地喹是一种体外抗埃博拉病毒活性的药物。使用替换药物治疗期间,患者并未出现其他明显的变化。

在西非,对于疑似埃博拉病毒感染(EVD)患者都应推荐进行抗疟治疗。佛牙埃博拉病毒感染治疗中心,蒿甲醚–本芴醇(抗疟治疗的一线药物组合)的供应在2014年8月中12天就已消耗完。这段时间内,患者接受青蒿琥酯-阿莫地喹联合治疗;阿莫地喹是一种体外抗埃博拉病毒活性的药物。使用替换药物治疗期间,患者并未出现其他明显的变化。

使用未校正及已校正的回归模型来标准化患者的数据,以评估使用青蒿琥酯-阿莫地喹联合治疗的EVD患者死亡的风险与使用蒿甲醚–本芴醇治疗的EVD患者以及未使用任何抗疟药物治疗的EVD患者的风险比。

2014年6月5日至10月24日之间,共有382名确诊的EVD患者进入佛牙埃博拉治疗中心接受治疗。其中,194名患者接受蒿甲醚–本芴醇治疗, 71名患者接受用青蒿琥酯-阿莫地喹治疗。结果发现,接受青蒿琥酯-阿莫地喹治疗的患者的临床特征与接受蒿甲醚–本芴醇以及未接受抗疟治疗的患者类似。最后,共有125名(64.4%)接受蒿甲醚–本芴醇治疗的患者死亡, 36名(50.7%)接受青蒿琥酯-阿莫地喹治疗的患者死亡。校正后分析,青蒿琥酯-阿莫地喹组患者死亡的风险较蒿甲醚–本芴醇组低31%(风险比为0.69;95% CI为0.54-0.89),对于不伴有疟疾的患者此结果更明显。

总而言之,研究结果发现,接受青蒿琥酯-阿莫地喹治疗的EVD患者死亡的风险较接受蒿甲醚–本芴醇治疗的患者低。但是,该研究分析并不能排除蒿甲醚–本芴醇治疗增加了死亡风险的可能,也不能排除临床特征不可测的患者使用青蒿琥酯-阿莫地喹治疗直接改变了患者的死亡风险的可能性。

原始出处:

Etienne Gignoux, M.P.H., Andrew S. Azman,et al.. Effect of Artesunate–Amodiaquine on Mortality Related to Ebola Virus Disease. N Engl J Med 2016; 374:23-32January 7, 2016DOI: 10.1056/NEJMoa1504605

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1818563, encodeId=7f7a1818563f4, content=<a href='/topic/show?id=793f9e9397e' target=_blank style='color:#2F92EE;'>#阿莫地喹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97939, encryptionId=793f9e9397e, topicName=阿莫地喹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05202500204, createdName=minhuang75_72521584, createdTime=Sat Aug 13 06:02:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010817, encodeId=6604201081e64, content=<a href='/topic/show?id=11a09905144' target=_blank style='color:#2F92EE;'>#青蒿琥酯#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99051, encryptionId=11a09905144, topicName=青蒿琥酯)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8fc0211, createdName=doctor-chen9582, createdTime=Fri Oct 21 13:02:00 CST 2016, time=2016-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650346, encodeId=df8916503469b, content=<a href='/topic/show?id=9e424155935' target=_blank style='color:#2F92EE;'>#埃博拉病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41559, encryptionId=9e424155935, topicName=埃博拉病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=639b24003788, createdName=tcm107hq, createdTime=Tue Aug 23 07:02:00 CST 2016, time=2016-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60639, encodeId=1da16063975, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60640, encodeId=04936064070, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=6, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60641, encodeId=785b60641f1, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60642, encodeId=1c3d60642d9, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57149, encodeId=6ecb5e149c2, content=学会了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569619FEB03536446.jpg, createdBy=85f81678980, createdName=Lynee劲飞扬, createdTime=Wed Jan 13 23:55:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=56937, encodeId=15535693e79, content=get, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569601E65B8046777.jpg, createdBy=90c91679211, createdName=马克6212, createdTime=Wed Jan 13 15:58:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255549, encodeId=2100125554978, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Jan 09 09:02:00 CST 2016, time=2016-01-09, status=1, ipAttribution=)]
    2016-01-27 doctording1

    不错,赞一个

    0

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    2016-01-27 doctording1

    这篇文章有一定深度

    0

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    2016-01-27 doctording1

    是一篇不错的文章

    0

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    2016-01-27 doctording1

    值得进一步关注

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1818563, encodeId=7f7a1818563f4, content=<a href='/topic/show?id=793f9e9397e' target=_blank style='color:#2F92EE;'>#阿莫地喹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97939, encryptionId=793f9e9397e, topicName=阿莫地喹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05202500204, createdName=minhuang75_72521584, createdTime=Sat Aug 13 06:02:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010817, encodeId=6604201081e64, content=<a href='/topic/show?id=11a09905144' target=_blank style='color:#2F92EE;'>#青蒿琥酯#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99051, encryptionId=11a09905144, topicName=青蒿琥酯)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8fc0211, createdName=doctor-chen9582, createdTime=Fri Oct 21 13:02:00 CST 2016, time=2016-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650346, encodeId=df8916503469b, content=<a href='/topic/show?id=9e424155935' target=_blank style='color:#2F92EE;'>#埃博拉病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41559, encryptionId=9e424155935, topicName=埃博拉病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=639b24003788, createdName=tcm107hq, createdTime=Tue Aug 23 07:02:00 CST 2016, time=2016-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60639, encodeId=1da16063975, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60640, encodeId=04936064070, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=6, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60641, encodeId=785b60641f1, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60642, encodeId=1c3d60642d9, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:37:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57149, encodeId=6ecb5e149c2, content=学会了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569619FEB03536446.jpg, createdBy=85f81678980, createdName=Lynee劲飞扬, createdTime=Wed Jan 13 23:55:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=56937, encodeId=15535693e79, content=get, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569601E65B8046777.jpg, createdBy=90c91679211, createdName=马克6212, createdTime=Wed Jan 13 15:58:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255549, encodeId=2100125554978, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Jan 09 09:02:00 CST 2016, time=2016-01-09, status=1, ipAttribution=)]
    2016-01-13 Lynee劲飞扬

    学会了

    0

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    2016-01-13 马克6212

    get

    0

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