法医学杂志 ›› 2020, Vol. 36 ›› Issue (2): 157-163.DOI: 10.12116/j.issn.1004-5619.2020.02.002

所属专题: 新型冠状病毒肺炎尸体检验

• 专题 • 上一篇    下一篇

氯喹类药物在新型冠状病毒肺炎治疗中的试用及其法医毒理学研究进展

段祎杰*, 刘茜*, 赵枢泉, 黄芳, 任亮, 刘良, 周亦武   

  1. 华中科技大学同济医学院法医学系,湖北 武汉 430030
  • 发布日期:2020-04-25 出版日期:2020-04-28
  • 通讯作者: 周亦武,男,博士,主任法医师,教授,主要从事法医病理学和法医毒理学教学、检案及研究;E-mail:zhouyiwu@hust.edu.cn 刘良,男,博士,主任法医师,教授,主要从事法医病理学和法医毒理学教学、检案及研究;E-mail:liuliang@mails.tjmu.edu.cn 任亮,男,博士,副主任法医师,从事法医病理学和法医毒理学教学及研究;E-mail:36918280@qq.com
  • 作者简介:段祎杰(1986—),男,博士,主检法医师,助理研究员,主要从事法医病理学、法医毒理学和神经系统发育障碍的遗传学研究;E-mail:gerichtsarzt@hotmail.com 刘茜(1980—),女,博士,副教授,主要从事法医病理学和法医毒理学教学、检案及研究;E-mail:caixe_liu0222@tom.com *段祎杰和刘茜为共同第一作者
  • 基金资助:
    湖北省新型肺炎应急科技攻关资助项目(2020FCA003)

Trial of Chloroquines in the Treatment of COVID-19 and Its Research Progress in Forensic Toxicology

DUAN Yi-jie*, LIU Qian*, ZHAO Shu-quan, HUANG Fang, REN Liang, LIU Liang, ZHOU Yi-wu   

  1. Department of Forensic Medicine, Tongji Medical College, Huanzhong University of Science and Technology, Wuhan 430030, China
  • Online:2020-04-25 Published:2020-04-28
  • Supported by:
     

摘要: 氯喹类药物是一类历史悠久的处方药,临床常用于抗疟疾及结缔组织病的治疗。2019年12月以来,在我国各地和世界多国发生了由严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus-2,SARS-CoV-2)引起的新型冠状病毒肺炎疫情。由于缺乏针对新型冠状病毒肺炎的药物,导致该病迅速蔓延且死亡率较高,因此亟待快速筛选抗SARS-CoV-2的特效药物,已批准使用的抗疟药磷酸氯喹被证实具有抗SARS-CoV-2的作用,并被纳入诊疗指南。但对磷酸氯喹引起急性中毒甚至死亡的风险意识也应同时加强,当前临床推荐剂量及疗程较以往治疗疟疾用药剂量偏大,多地已要求临床密切监测不良反应。本文从法医学的角度,对氯喹类药物的药理作用、中毒与毒理作用机制、体内代谢与分布及法医学鉴定要点进行综述,以期为法医学实践及临床工作提供帮助。

 

关键词: 法医病理学, 法医毒理学, 氯喹, 新型冠状病毒肺炎, 综述

Abstract: Chloroquines are the long-established prescription drug, which are often used clinically to treat malaria and connective tissue diseases. Since December 2019, corona virus disease 2019 (COVID-19) outbreaks caused by 2019 novel coronavirus (2019-nCoV) has occurred in China and many countries around the world. Due to the lack of drugs against COVID-19, the disease spreads rapidly and the mortality rate is relatively high. Therefore, specific drugs against 2019-nCoV need to be quickly screened. The antimalarial drug chloroquine phosphate which has already been approved is confirmed to have an anti-2019-nCoV effect and has been included in diagnostic and therapeutic guidelines. However, awareness of the risk of chloroquine phosphate causing acute poisoning or even death should be strengthened. The current dosage recommended in clinical treatment is larger than that in previous treatment of malaria and the period of treatment is longer. Many provinces have required close clinical monitoring of adverse reactions. This paper reviews the pharmacological effects, poisoning and toxicological mechanisms, in vivo metabolism and distribution, and forensic issues of chloroquine drugs, in order to provide help to forensic practice and clinical work.

Key words: forensic pathology, forensic toxicology, chloroquine, corona virus disease 2019, review

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