摘要
早期抗病毒治疗是改善流行性感冒和禽流感患者预后的关键。目前临床用于抗流感病毒的药物按作用机制可大致分为两类,一类作用于病毒表面的糖蛋白神经氨酸酶,另一类作用于离子通道M2蛋白。我国目前常用的抗流感病毒药物主要有奥司他韦、扎那米韦、金刚烷胺和金刚乙胺。抗流感病毒治疗应在发病后48h内尽早进行;在缺乏耐药检测结果的情况下,甲型流感病毒可选用奥司他韦、扎那米韦、金刚烷胺或金刚乙胺进行治疗,乙型流感病毒选用奥司他韦或扎那米韦治疗。耐药分析表明,对于甲型H1N1型流感、H5N1型禽流感和H7N9型禽流感应首选神经氨酸酶抑制剂治疗,疗程通常为5d,对重症患者可增加药物剂量并延长治疗时间。流感病毒耐药性的出现给抗流感病毒治疗带来了挑战,可考虑采用具有不同作用机制的抗流感病毒药物联合治疗耐药流感病毒感染。
Early antiviral treatment is a key measure to improve the prognosis of the patients with influenza and avian influenza. At present the antiviral influenza drugs used in the clinic can be roughly divided into two categories according to their mechanisms. One category is to act on the viral surface glycoproteins neuraminidase and the other on the ion channel M2 protein. The common antiviral influenza drugs used mainly in China are oseltamivir, zanamivir, amantadine and rimantadine now. The antiviral influenza treatment should be given as early as possible after its occurrence within 48 h. In case of lack of drug resistance test results, influenza A virus can be treated with oseltamivir, zanamivir, amantadine or rimantadine, and influenza B virus with oseltamivir or zanamivir. The drug resistance analysis shows that type A H1N1 influenza, HSN1 and H7N9 avian influenzas should be treated with neuraminidase inhibitors firstly, and the course of its treatment is usually 5 days. But for the patients with severe diseases, the dosages should be increased and treatment time prolonged. Emergence of drug resistance of virus has brought a challenge for the antiviral treatment. Joint anti-influenza virus treatment may be considered to be used in the treatment of the infections caused by the resistant influenza virus.
出处
《上海医药》
CAS
2013年第11期3-7,共5页
Shanghai Medical & Pharmaceutical Journal
关键词
流行性感冒
禽流感
抗病毒治疗
influenza
avian influenza
antiviral treatment
