新型冠状病毒肺炎患者合并心脏和肝脏损害的临床分析  

Heart and liver damages in coronavirus disease-2019

作　　者：李翠芝[1] 李美瑜[1] 甘露 张影[3] 雷春亮[4] LI Cui-zhi;LI Mei-yu;GAN Lu;ZHANG Ying;LEI Chun-liang(Department of Cardiology,Guangzhou Eighth People's Hospital,Guangzhou 510440,Guangdong,China;不详)

机构地区：[1]广州市第八人民医院心血管内科,广东广州510440 [2]广州市第八人民医院超声科,广东广州510440 [3]广州市第八人民医院外科,广东广州510440 [4]广州市第八人民医院肝病科,广东广州510440

出　　处：《广东医学》2020年第9期874-877,共4页Guangdong Medical Journal

基　　金：广州市卫生健康科技项目(20191A010028)。

摘　　要：目的回顾性分析新型冠状病毒肺炎(COVID-19)患者发病过程中合并心脏和肝脏损害的情况。方法选取82例COVID-19患者,其中普通型组58例,重型和危重型组24例,对纳入病例病程中出现的与心脏、肝脏功能有关的临床表现、心电图及实验室检查结果进行分析。结果82例COVID-19患者中心肌损害20例(24.3%),肝脏损害38例(46.3%),多数症状较轻。重型和危重型组患者肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肌钙蛋白I(cTnI)、丙氨酸氨基转移酶(ALT)、直接胆红素(DBIL)数值均高于普通型组患者,两组间差异有统计学意义(P=0.015,P<0.05,P=0.012、0.019、0.026),而白蛋白(Alb)则明显低于普通型组患者,两组间比较差异有统计学意义(P<0.05)。结论部分COVID-19患者病程中合并心脏、肝脏损害,多数症状较轻,这种损伤可能主要是由全身炎症反应所致的继发性损伤,缺氧及药物可进一步加剧损害。Objective To analyze the clinical characteristics of patients of coronavirus disease 2019(COVID-19)and their heart and liver damages.Methods Eighty-two patients with COVID-19 were selected as the research subjects.There were 58 cases in general group and 24 cases in severe and critical group.The clinical manifestations,electrocardiogram and heart and liver laboratory data were analyzed.Results Among 82 COVID-19 cases,20(24.3%)showed heart damages and 38(46.3%)showed liver damages,though most of them only had mild symptoms.The levels of creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),troponin I(cTnI),alanine amino(ALT)and direct bilirubin(DBIL)in the severe and critical group were significantly higher than those in general group;while the albumin(Alb)in general group was significantly higher than that in the severe and critical group(P<0.05).Conclusion Some COVID-19 patients have heart and liver damages during the course of the disease,but most of them only have mild symptoms.The damage may be mainly caused by systemic inflammatory response and enhanced by hypoxia and side effect of medicines.

关 键 词：新型冠状病毒肺炎 心脏 肝脏 合并症 

分 类 号：R563.1[医药卫生—呼吸系统] R542.2[医药卫生—内科学]