新型冠状病毒肺炎急性肝损伤的发生情况及相关危险因素分析  

The incidence of acute liver injury in COVID-19 and its related risk factors analysis

作　　者：窦爱华[1] 郑俊福[1] 惠威[1] 刘梅[1] 高文[1] 魏琳琳[1] 郑小勤 杨雪[1] 苏璇 王扬[1] 徐斌[1] Dou Aihua;Zheng Junfu;Hui Wei;Liu Mei;Gao Wen;Wei Linlin;Zheng Xiaoqin;Yang Xue;Su Xuan;Wang Yang;Xu Bin(Depratment of Hepatologyand Endocrinology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病内分泌科,100069

出　　处：《北京医学》2020年第6期493-495,499,共4页Beijing Medical Journal

基　　金：首都医科大学附属北京佑安医院中青年孵育项目(YNKTYJ20180101)。

摘　　要：目的探讨新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者中急性肝损伤的发生率及其相关危险因素。方法选取2020年1~2月首都医科大学附属北京佑安医院收治的确诊及疑似COVID-19患者103例,收集患者入院时的首次肝功能检查结果,分析急性肝损伤的发生率,采用logistic回归分析其相关危险因素。结果COVID-19确诊患者急性肝损伤发生率为28.0%(23/82),疑似患者为4.8%(1/21),差异有统计学意义(P=0.02);确诊患者ALT、AST明显高于疑似患者,差异有统计学意义(P<0.05);T-BIL两组比较差异无统计学意义。确诊患者中,轻型及普通型53例,急性肝损伤发生率28.3%(15/53),重型及危重型29例,急性肝损伤发生率27.6%(8/29),差异无统计学意义(P>0.05);CRP(OR=1.02,95%CI:1.01~1.03,P=0.04)是COVID-19患者发生急性肝损伤的危险因素。结论COVID-19患者在起病早期就可出现急性肝损伤,以转氨酶升高为主,通常不伴有胆红素的异常。急性肝损伤与患者临床严重程度不相关,与CRP水平存在明显相关性。Objective To investigate the incidence of acute liver injury in coronavirus disease 2019(COVID-19)patients and its related risk factors.Methods From January to February 2020,103 diagnosed or suspected cases of COVID-19,hospitalized in the Beijing Youan Hospital were enrolled in this study.The incidence of acute liver injury were analyzed and risk factors of acute liver injury were analyzed with logistic regression.Results The incidence of acute liver injury in diagnosed cases of COVID-19 was 28.0%(23/82),the incidence of acute liver injury in suspected cases was 4.8%(1/21),with significant difference between the two groups(P=0.02).The mean of ALT and AST in diagnosed cases of COVID-19 were39(5,264)U/L and 30(5,252)U/L,which were significantly higher than those of suspected cases[22(11,51)U/L,22(3,39)U/L,P<0.05].There was no statistical difference of T-BIL between the two groups.In diagnosed cases,the incidence of acute liver injury in light and popular type of COVID-19 was 28.3%(15/53),which was 27.6%(8/29)in severe and critically severe type(P>0.05).The related risk factors for acute liver injury in COVID-19 was CRP(OR=1.02,95%CI:1.01~1.03,P=0.04).Conclusions Acute liver injury in COVID-19 can appear in the early stage of COVID-19.There is dominant increase of transaminase,usually without the abnormality of T-BIL in acute liver injury in COVID-19.There is no correlation between acute liver injury and clinical severity,but there is significant correlation between acute liver injury and CRP protein level.

关 键 词：新型冠状病毒肺炎 急性肝损伤 危险因素 发生率 

分 类 号：R563.1[医药卫生—呼吸系统] R575[医药卫生—内科学]