通讯作者: 黄小理, 934974069@qq.com

DOI：10.12201/bmr.202512.00050

Real-World Study on the effects of Nirmatrelvir/Ritonavir on Liver and Kidney Function in COVID-19 Patients

• 摘要：目的：本研究旨在探讨奈玛特韦/利托那韦治疗对COVID-19患者肝肾功能的实际影响,以便为临床治疗提供科学依据,确保患者用药的安全性。方法：收集2022年10月至2025年02月期间,接受奈玛特韦/利托那韦治疗的COVID-19患者的临床资料。根据患者治疗前的肝肾功能进行亚组分析。采用t检验,卡方检验及非参数检验比较患者治疗前和治疗后3、7、14、21天的肝功能指标和肾功能指标的差异。结果：共纳入106名接受奈玛特韦/利托那韦治疗的COVID-19患者。其中,男性患者有65例,女性患者有41例。肝功能监测方面,经亚组分析,肝功能正常患者中在治疗后14d、21d的γ-谷氨酰基转移酶(GGT)水平较治疗前明显增高(P＜0.05)。在轻度肝损伤患者中,治疗后3d的天门冬氨酸氨基转移酶(AST)水平显著低于治疗前(P＜0.05)。而在肾功能监测方面,在30ml/min/1.73m2＜ 肾小球滤过率 (eGFR) ≤60ml/min/1.73m2组中,治疗后7天的血尿素氮(URea)水平显著低于治疗前(P＜0.05)。在60ml/min/1.73m2＜eGFR≤90ml/min/1.73m2组中,在治疗后7天的血清肌酐(Creat)较治疗前有所减少(P＜0.05)。在eGFR＞90ml/min/1.73m2组中,与治疗前相比,患者治疗后14天的URea水平明显降低,差异有统计学意义(P＜0.05)。结论：奈玛特韦/利托那韦对COVID-19患者具有良好的肝肾安全性。在权衡利弊后,肝肾功能不全的COVID-19患者可考虑使用奈玛特韦/利托那韦治疗,在用药期间应进行肝肾功能监测。然而,奈玛特韦/利托那韦对严重肝肾功能不全患者的影响仍需要进一步明确。

  关键词： 奈玛特韦/利托那韦; COVID-19; 肝功能; 肾功能

   

  Abstract: Objective: The purpose of this study is to explore the actual effects of Nirmatrelvir/Ritonavir treatment on liver and kidney function in COVID-19 patients, in order to provide scientific basis for clinical treatment and ensure the safety of medication for patients. Method: Collect clinical data of COVID-19 patients treated with Nirmatrelvir/Ritonavir from October 2022 to February 2025. Perform subgroup analysis based on the patients liver and kidney function before treatment. Using t-test, chi square test, and non-parametric test to compare the differences in liver and kidney function indicators between patients before treatment and 3, 7, 14, and 21 days after treatment. Result: A total of 106 COVID-19 patients receiving treatment with Nirmatrelvir/Ritonavir were included. Among them, there were 65 male patients and 41 female patients. In terms of liver function monitoring, subgroup analysis showed that the levels of γ-glutamyltransferase (GGT) in patients with normal liver function were significantly increased at 14 and 21 days after treatment compared to before treatment (P＜0.05). In patients with mild liver injury, the level of aspartate aminotransferase (AST) after 3 days of treatment was significantly lower than before treatment (P＜0.05). In terms of renal function monitoring, in the group with 30ml/min/1.73m2＜glomerular filtration rate (eGFR) ≤ 60ml/min/1.73m2, the blood urea nitrogen (URea) levels after 7 days of treatment were significantly lower than before treatment (P＜0.05). In the group of 60ml/min/1.73m2＜eGFR ≤ 90ml/min/1.73m2, serum creatinine (Cream) decreased after 7 days of treatment compared to before treatment (P<0.05). In the eGFR＞90ml/min/1.73m 2 group, the URea level of patients significantly decreased after 14 days of treatment compared to before treatment, and the difference was statistically significant (P＜0.05). Conclusion:

  Key words: Nematovir/Letonavir; COVID-19; Liver function; Renal function

  提交时间：2025-12-18

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• 序号	提交日期	编号	操作
  1	2025-11-28	10.12201/bmr.202512.00050V1	下载

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