目的 探討阿茲夫定治療75歲以上新型冠狀病毒肺炎（COVID-19）的安全性。方法 通過醫(yī)院電子病例系統(tǒng)收集2022年12月—2023年2月南京醫(yī)科大學(xué)附屬老年醫(yī)院應(yīng)用阿茲夫定治療的≥75歲COVID-19患者病例資料，對阿茲夫定的不良反應(yīng)發(fā)生情況（不良反應(yīng)名稱、發(fā)生時間、臨床表現(xiàn)、嚴重程度、關(guān)聯(lián)性評價等）以及轉(zhuǎn)歸等進行回顧性分析。結(jié)果 納入74例患者發(fā)生不良反應(yīng)的有28例（37.8%）。28例患者中，消化系統(tǒng)癥狀者20例（主要表現(xiàn)為肝功能異常10例、腹瀉7例、惡心嘔吐2例、淀粉酶升高1例），血液系統(tǒng)不良反應(yīng)6例（血小板升高），泌尿系統(tǒng)（肌酐升高）3例，心血管系統(tǒng)癥狀（心動過速）2例，電解質(zhì)紊亂1例；其中2例患者同時出現(xiàn)2個系統(tǒng)癥狀，分別為消化系統(tǒng)合并血液系統(tǒng)和消化系統(tǒng)合并心血管系統(tǒng)以及2例患者發(fā)生消化系統(tǒng)2個癥狀。發(fā)生1級不良反應(yīng)26例（92.8%），2級1例（3.6%），嚴重不良反應(yīng)患者1例（3.6%）。其中2例患者因不良反應(yīng)停藥，1例為不能耐受惡心嘔吐停藥，1例為嚴重肝功能損傷停藥。結(jié)論 阿茲夫定治療75歲以上老年COVID-19患者安全性較好，主要表現(xiàn)為輕微的消化系統(tǒng)癥狀，以肝功能異常、腹瀉較為多見。

Objective To explore the safety of Azvudine in the treatment of patients with coronavirus disease 2019 (COVID-19) over 75 years. Methods Medical records of patients with COVID-19 over 75 years who were hospitalized in Geriatric Hospital of Nanjing Medical University and treated with Azvudine from December 2022 to February 2023 were collected through the hospital electronic medical record system. The occurrence (name, time of occurrence, clinical manifestations, severity, etc.) and outcomes of adverse reactions were analyzed retrospectively. Results Adverse reactions occurred in 28 of 74 patients (37.8%). Among the 28 patients, 20 cases had digestive system symptoms (mainly manifested as abnormal liver function in 10 cases, diarrhea in seven cases, nausea and vomiting in two cases, amylase increase in one case), six cases had blood system symptoms (thrombocytosis), three cases had urinary system symptoms (creatinine elevation), two cases had cardiovascular system symptoms (tachycardia), one case had electrolyte disturbance (potassium reduction). Of them, two patients had two systemic symptoms at the same time, namely digestive system combined with blood system and digestive system combined with cardiovascular system, and two patients had two symptoms of digestive system. The severity of adverse reactions was grade one in 26 patients (92.8%), grade two in one patient (3.6%), and serious adverse reaction of grade five in one patient(3.6%). Two patients discontinued the drug because of intolerance to nausea and vomiting and severe liver injury respectively. Conclusion Azvudine has a good safety in the treatment of over 75 years with COVID-19. The adverse reaction is mild digestive system symptoms, mainly abnormal liver function and diarrhea.

R978.7

南京藥學(xué)會-常州四藥醫(yī)院藥學(xué)科研基金項目（2017YX016）；江蘇省藥學(xué)會-奧賽康臨床藥學(xué)基金項目（A201710）