摘要
目的计算机检索磷酸氯喹用于感染性疾病的文献并提取分析其有效性和安全性,为新型冠状病毒肺炎(COVID-19)的治疗提供参考。方法检索Medline、Embase、Cochrane Central Register of Controlled Trials(CENTRAL)、中国知网(CNKI)数据库,检索时限均为建库至2020年2月27日,对符合纳入标准的文献的主要结果进行描述性分析。结果初筛文献2788篇,筛选后最终纳入磷酸氯喹用于感染性疾病文献481篇。其中用于疟疾456篇、获得性免疫缺陷综合征(AIDS)4篇、严重急性呼吸综合征(SARS) 2篇、寨卡病毒(ZIKV)4篇、人感染禽流感1篇、流感4篇、埃博拉病毒(EBOV)2篇、登革热病毒(DENV)7篇、COVID-19研究1篇。磷酸氯喹治疗疟疾疗效确切,体外研究显示氯喹能抑制获得性免疫缺陷病毒(HIV)、SARS-CoV、ZIKV、DENV和SARS-CoV-2,动物研究显示磷酸氯喹可以抑制小鼠中甲型禽流感诱导的肺自噬细胞增多,但不能抑制病毒载量和促炎细胞因子。此外,磷酸氯喹对埃博拉病毒无效。磷酸氯喹除了恶心、呕吐等常见不良反应,还可能导致心脏及眼部毒性。结论磷酸氯喹对于HIV、SARS-CoV、ZIKV、DENV和SARS-CoV-2具有体外抑制作用,但缺乏临床研究。建议按照诊疗方案给药时,应该警惕磷酸氯喹的不良反应,合并用药时需要考虑药物的相互作用。
Objective To provide references for the treatment of COVID-19 by systematic literature search and analysis of chloroquine phosphate in the treatment of virus infectious diseases.Methods Computer databases searches from Pubmed,Embase,Cochrane Central Register of Controlled Trials(CENTRAL),CNKI databases were carried out within the time limit from the establishment of the databases to February 27,2020.Descriptive analysis was made on the main results of the eligible articles that met the inclusion criteria.Results There were 2788 initially screened literatures,and 481 articles of chloroquine phosphate for viral infectious diseases were finally included.Chloroquine phosphate was used in 456 studies of malaria research,4 studies of acquired immunodeficiency syndrome(AIDS),2 studies of severe acute respiratory syndrome(SARS),4 studies of Zika virus(ZIKV),1 study of human infection with avian influenza,4 studies of flu,2 studies of Ebola virus(EBOV),7 studies of dengue,and one study on the treatment of coronavirus disease 2019(COVID-19).The results show that chloroquine phosphate was effective in treating malaria.In vitro studies have shown that chloroquine phosphate can inhibit HIV,SARS-CoV,ZIKV,DENV,and COVID-19.Animal studies have shown that chloroquine phosphate can inhibit the increase of pulmonary autophagy induced by avian influenzain mice,but cannot inhibit viral load and pro-inflammatory cytokines.Chloroquine phosphate was not effective against ebola.For the drug safety,chloroquine phosphate caused nausea,vomiting,and other common adverse reactions,and it also led to heart and eye toxicity.Conclusion Chloroquine phosphate has inhibitory effects on HIV,SARS-CoV,ZIKV,DENV,and SARS-CoV-2 in vitro.It is suggested that the adverse reactions of chloroquine phosphate should be paid attention to when the drug is given according to the diagnosis and treatment scheme,and the drug interaction should be considered when the drugs are combined.
作者
刘颖
苏娜
陈昭阳
蒋艾豆
徐珽
LIU Ying;SU Na;CHEN Zhaoyang;JIANG Aidou;XU Ting(Department of Pharmacy,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《医药导报》
CAS
北大核心
2020年第6期784-790,共7页
Herald of Medicine
基金
华西医院临床研究孵化项目(2018HXFH048)
四川省软科学研究计划项目(2018ZR0212)。
