目的: 探讨奥司他韦对成人急性重症病毒性肺炎患者IL-1β、IL-6、TNF-α及免疫功能的影响。方法：选取我院2017年12月至2019年3月收治的64例成人急性重症病毒性肺炎患者作为研究对象，分为对照组和观察组，每组各32例。对照组采取利巴韦林药物治疗，观察组采取奥司他韦药物治疗。比较两组临床疗效、临床症状体征及肺部影像学积分和病毒核酸转阴情况、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）炎症指标、CD3+T细胞、CD4+T细胞、CD8+T细胞和自然杀伤细胞（NK细胞）免疫指标及不良反应发生情况。结果：对照组总治愈率56.25%明显低于观察组96.88%（P<0.05）;对照组发热消退时间、乏力缓解时间、喘憋消失时间、气促消失时间、湿性啰音消失时间均明显多于观察组（P<0.05）；对照组肺部影像学积分高于观察组，病毒核酸转阴天数多于观察组（P<0.05）。治疗前两组IL-1β、IL-6、TNF-α炎症指标比较无差异（P>0.05）；治疗前两组IL-1β、IL-6、TNF-α、hs-CRP炎症指标比较无差异（P>0.05）；治疗后IL-1β、IL-6、TNF-α、hs-CRP炎症水平均较治疗前下降，且观察组炎症指标水平下降程度高于对照组（P<0.05）。观察组CD3+T细胞、CD4+T细胞、CD8+T细胞和NK细胞免疫指标水平明显高于对照组（P<0.05）。两组恶心呕吐、皮疹和头晕等不良反应比较无差异（P>0.05）。结论：应用奥司他韦治疗成人急性重症病毒性肺炎患者，其疗效显著，可抑制IL-1β、IL-6、TNF-α和hs-CRP水平提高，明显改善其免疫功能，临床可进一步推广。

Abstract Objective: To investigate the effects of oseltamivir on IL-1β, IL-6, TNF-α and immune function in adults with acute severe viral pneumonia. Methods: Sixty-four adult patients with acute severe viral pneumonia admitted to our hospital from December 2017 to March 2019 were enrolled in the study. They were divided into control group and observation group, with 32 cases in each group. The control group was treated with ribavirin and the observation group was treated with oseltamivir. The clinical efficacy, clinical symptoms and signs, lung imaging scores and viral nucleic acid negative conditions, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α were compared between the two groups. TNF-α) inflammation index, CD3+ T cells, CD4+ T cells, CD8+ T cells and natural killer cells (NK cells) immune indicators and adverse reactions occurred. Results: The total cure rate of the control group was 56.25%, which was significantly lower than that of the observation group (96.88%) (P<0.05). The fever regression time, fatigue remission time, wheezing disappearance time, shortness of breath disappearance, and disappearance time of wet voice were significantly higher in the control group than in the observation group (P<0.05). The imaging score of the lung in the control group was higher than that in the observation group. The number of negative days of nucleic acid was higher than that of the observation group (P<0.05). There was no difference in the indexes of IL-1β, IL-6 and TNF-α between the two groups before treatment (P>0.05). There was no difference in the indicators of IL-1β, IL-6, TNF-α and hs-CRP between the two groups before treatment. (P>0.05); IL-1β, IL-6, TNF-α, hs-CRP inflammation levels decreased after treatment, and the level of inflammation index in the observation group decreased compared with the control group (P<0.05). The levels of CD3+ T cells, CD4+ T cells, CD8+ T cells and NK cells in the observation group were significantly higher than those in the control group (P<0.05). There were no differences in adverse reactions such as nausea and vomiting, rash and dizziness between the two groups (P>0.05). Conclusion: The application of oseltamivir in the treatment of acute acute viral pneumonia in adults has a significant effect, which can inhibit the levels of IL-1β, IL-6, TNF-α and hs-CRP, and significantly improve their immune function. .