111例老年新型冠状病毒肺炎患者肝功能变化的特点  

Characteristics of liver function changes in 111 elderly patients with COVID-19 pneumonia

作　　者：徐玲[1] 朱彬[1] 梁博云 刘京 卢思虹 李苏萌 郑昕[1] Xu Ling;Zhu Bin;Liang Boyun;Liu Jing;Lu Sihong;Li Sumeng;Zheng Xin(Department of Infectious Diseases,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 432200,China)

机构地区：[1]华中科技大学同济医学院附属协和医院感染科,武汉432200

出　　处：《中华肝脏病杂志》2022年第5期527-533,共7页Chinese Journal of Hepatology

基　　金：国家科技重大专项(2018ZX10723203,2018ZX10302206);中央高校基本科研业务费专项资助基金(2020kfyXGYJ016)。

摘　　要：目的回顾性分析111例老年新型冠状病毒肺炎(COVID-19)肝功能变化特点以及影响因素。方法纳入2020年2月5日至3月3日华中科技大学同济医学院附属协和医院感染科收治的111例老年COVID-19患者,按照疾病严重程度以及肝功能情况分为重症组(n=40)和普通组(n=71)、肝功异常组(n=86)和肝功能正常组(n=25)分析患者肝功能相关指标总胆红素(TBil)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)和γ-谷氨酰转移酶(GGT)变化及相关影响因素。结果111例患者中有86例(77.5%)出现不同程度的肝功能异常,其中28例(25.2%)出现肝损伤。重症组患者TBil、AST、ALP和GGT的异常率显著高于普通组患者(P值均<0.05);肝功能异常组与正常组患者在年龄、利巴韦林、糖皮质激素、洛匹那韦利托那韦片的应用上差异无统计学意义(P值均>0.05),肝功能异常组男性比例显著高于肝功能正常组(P<0.05)。结论老年COVID-19患者出现肝功能异常的比例较高,重症组患者更易出现TBil、AST、ALP和GGT升高;老年患者肝功能异常可能与病毒直接感染肝脏以及感染后机体的炎症免疫反应有关。Objective To retrospectively analyze the characteristics and influencing factors of liver function changes in 111 elderly patients with COVID-19 pneumonia.Methods 111 elderly patients with COVID-19 admitted to the Department of Infectious Diseases,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from February 5 to March 3,2020 were enrolled.According to the severity of disease and liver function condition,they were divided into severe group(n=40),normal group(n=71),abnormal liver function group(n=86)and normal liver function group(n=25).The indexes related to liver function changes[total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)andγ-glutamyl transferase(GGT)]and related influencing factors were analyzed.Results Among 111 cases,86(77.5%)had abnormal liver function of varying degrees,and 28(25.2%)had liver injury.The abnormal rates of TBil,AST,ALP and GGT were significantly higher in the severe group than normal group(P<0.05).There were no significant differences in age,ribavirin,glucocorticoid and the application of lopinavir-ritonavir tablets between the abnormal liver function and the normal group(P>0.05).The proportion of male was significantly higher in the abnormal liver function than normal liver function group(P<0.05).Conclusion Elderly COVID-19 patients have a higher proportion of abnormal liver function,and patients in the severe group are more likely to have higher level of TB,AST,ALP and GGT.The abnormal liver function may be related to the direct viral infection of the liver and the inflammatory immune response of the body after infection in elderly patients.

关 键 词：新型冠状病毒肺炎 老年人 肝功能 临床特点 影响因素 

分 类 号：R563.1[医药卫生—呼吸系统]