羟氯喹联合阿奇霉素对新型冠状病毒感染住院患者的心脏毒性研究

目的：
研究在治疗新型冠状病毒感染的真实临床实践中，根据俄罗斯联邦卫生部推荐剂量*使用羟氯喹联合阿奇霉素的安全性和耐受性。羟氯喹联合阿奇霉素对新型冠状病毒感染住院患者的心脏毒性研究。
 
研究对象与方法：
132名患者（男性67名，女性70名，平均年龄：59.2±9.3 岁）参与了该前瞻性研究.其中59%的患者有心血管疾病。112名患者接受了羟氯喹+阿奇霉素联合用药（第一组），其余20名患者接受了不具有潜在心脏毒性的用药方案（第二组）。对入院时以及治疗5至7天后的QTc间期均进行了测算，记录了新出现的心律失常及心脏传导性异常，其他不良反应，及临床死亡。经计算得出了相对风险（RR）和95%置信区间。
 
结果：
第一组中有22.3%的患者QTc间期在正常值范围内延长，在第二组中该比例为15%；第一组1.8%的患者QTc间期延长至临界水平480mc。两组间发生QTc间期延长的患者数量无统计学显著性差异（相对风险=1.488，95%置信区间=0.496-4.466，p=0.478）。未记录到新的心律失常和心脏传导性异常，未发生过敏反应。大部分患者对羟氯喹+阿奇霉素联合用药耐受性良好。第一组患者死亡率为1.8%，在第二组为5%，该差异无统计学意义，（p=0.375）
 
结论：
住院条件下，根据俄罗斯联邦卫生部推荐剂量*联合应用羟氯喹和阿奇霉素对患有心血管系统基础疾病的患者是安全的。

*译者注：羟氯喹首日剂量为800 mg，而后每日400mg，持续五日。

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