462例新型冠状病毒肺炎合并肝损伤患者临床特征及与重症关系分析  

Clinical characteristics of 462 coronavirus disease 2019 patients with liver injury and the serum albumin maybe a potential indicator to estimate the severity of COVID-19

作　　者：于海涛 邢媛 孙青刚 陈吉刚 刘承军 李露嘉 吕坤聚 孟宪泽 林慧艳 YU Hai-tao;XING Yuan;SUN Qing-gang;CHEN Ji-gang;LIU Chen-gjun;LI Lu-jia;LV Kun-jun;MENG Xian-ze;LIN Hui-yan(No.971 Hospital of people′s Liberation Army Navy,Qingdao,Shandong 266071,china;No.7 Infection Division,Guanggu District,Maternal and Child Hospital of Hubei Province,Wuhan 430020,china;Department of Clinical Laboratory,Joint Support Force 940 Hospital,Lanzhou,Gansu 730000,china)

机构地区：[1]海军第九七一医院,260071 [2]湖北省妇幼保健院光谷院区感染七科,430020 [3]联勤保障部队第九四〇医院检验科,730050

出　　处：《现代消化及介入诊疗》2020年第12期1571-1574,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学青年科学基金项目(81700272);湖北省妇幼保健院光谷院区院内项目(2020-FYGG-039,2020-FYGG-040)。

摘　　要：目的了解新型冠状病毒肺炎(COVID-19)合并肝损伤患者临床表现及肝损伤与重症关系,寻找疾病转归预后指标,为临床诊疗提供参考。方法收集2020年2月19日至3月23日湖北省妇幼保健院光谷院区收治的1641例COVID-19住院患者的病历资料。回顾性分析肝损伤与COVID-19重症的关系,进一步分析肝功能相关指标谷丙转氨酶、谷草转氨酶、总胆红素、血清白蛋白、碱性磷酸酶与COVID-19重症化的危险性。结果28.7%(462/1612)的COVID-19患者出现肝损伤。肝损伤组重症比例为35.1%,显著高于肝功能正常组的10.3%(P<0.001)。谷丙转氨酶、谷草转氨酶、总胆红素、血清白蛋白、碱性磷酸酶均为COVID-19患者重症化的影响因素(P均<0.05)。多因素Logistic回归显示血清白蛋白是影响COVID-19患者重症化的独立危险因素(OR=8.201,P<0.001)。结论COVID-19患者中肝损伤是重症化的危险因素。而血清白蛋白水平是影响COVID-19患者重症化的独立危险因素,其可能是判断COVID-19严重程度和预后的指标之一。Objective To investigate the clinical characteristics of coronavirus disease 2019(COVID-19)patients with liver injury,and the relationship of liver injury and severity of COVID-19,searching for prognostic indicator to provide the reference for clinical treatment.Methods The data of 1641 hospitalized patients with COVID-19 in Guanggu District,Maternal and Child Hospital of Hubei Province during February 19,2020 to March 23 were collected.The relationship between liver injury and the severity of COVID-19 was retrospectively analyzed.To analyze liver function indicator[including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(T-Bil),serum albumin(ALB),alkaline phosphatase(ALP)]and severity of COVID-19.Results Our data showed that liver injury occurred in 28.7%(462/1612)of COVID-19 patients.Compared to patients with normal liver function,the proportion of severe COVID-19 was significantly higher in liver injury group(35.1%vs 10.3%)(p<0.001).All of ALT,AST,T-Bil,ALB,ALP could be factors affecting the severity of COVID-19(P<0.05).Multivariate logistic regression results showed that the serum albumin level was independent risk factor of severity of COVID-19(OR=8.201,P<0.001).Conclusion Liver injury is risk factor of the severity in COVID-19 patients.And the serum albumin is the independent risk factor affecting the severity,which is a potential indicator to estimate the severity and prognosis of COVID-19.

关 键 词：新型冠状病毒肺炎 肝损伤 血清白蛋白 谷丙转氨酶 谷草转氨酶 总胆红素 碱性磷酸酶 

分 类 号：R446.11[医药卫生—诊断学]