摘要目的:比较浙江省新型冠状病毒肺炎(新冠肺炎)患者早期接受阿比多尔＋洛匹那韦/利托那韦＋重组干扰素α-2b(Recombinant interferon α-2b，rIFNα-2b)三药联合与洛匹那韦/利托那韦＋rIFNα-2b二药联合的抗病毒效果。方法:对2020年1月22日至2月16日浙江省15家医疗机构纳入的237例新冠肺炎患者开展多中心、前瞻性研究。所有患者均接受rIFNα-2b(500万U，2次/d)雾化吸入治疗，其中196例患者同时口服阿比多尔(200 mg，3次/d)＋洛匹那韦/利托那韦(2片，1次/12 h)作为三联抗病毒治疗组，41例患者口服洛匹那韦/利托那韦(2片，1次/12 h)作为二联抗病毒治疗组；进一步将接受三联抗病毒治疗患者分为48 h内、3～5 d和>5 d开始抗病毒治疗组。比较三联和二联抗病毒药物，以及三联药物不同抗病毒时间的治疗效果。采用SPSS 17.0软件对数据进行分析。结果:三药联合治疗组呼吸道标本病毒核酸转阴时间为(12.2±4.7) d，较两药联合组[(15.0±5.0) d]时间缩短( t＝6.159， P<0.01)。三药联合治疗组住院中位时间[12.0(9.0，17.0) d ]亦短于两药联合治疗组[15.0(10.0，18.0) d]( H＝2.073, P<0.05)。三药联合治疗组在48 h内、3～5 d以及>5 d开始抗病毒治疗，从发病到病毒核酸转阴的中位时间分别为13.0(10.0，17.0)、17.0(13.0，22.0)和21.0(18.0，24.0) d，从抗病毒到病毒核酸转阴的平均时间分别为(11.8±3.9)、(13.5±5.1)和(11.2±4.3) d，三组之间差异具有统计学意义( Z＝32.983和6.722， P<0.01或<0.05)。 结论:三药联合治疗组较二药联合治疗组可以缩短呼吸道标本病毒核酸转阴时间和住院时间，且三药联合抗病毒治疗时间越早，病毒核酸转阴时间越快。

abstractsObjective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.