肝移植受者感染新型冠状病毒情况分析  

Clinical characteristics of COVID-19 infection in liver transplant recipients

作　　者：崔自强 陈雅洁 窦剑[1] 曹经琳[1] 王洋[1] 赵鑫[1] 曾强[1] 刘保旺[1] 高天益 Cui Ziqiang;Chen Yajie;Dou Jian;Cao Jinglin;Wang Yang;Zhao Xin;Zeng Qiang;Liu Baowang;Gao Tianyi(Department of Hepatobiliary Surgery,Hebei Medical University Third Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院肝胆外科,石家庄050051

出　　处：《中华肝胆外科杂志》2023年第11期832-835,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的分析肝移植受者感染新型冠状病毒(新冠病毒)的情况。方法回顾分析河北医科大学第三医院2022年11月至2023年1月期间肝移植受者新冠病毒感染相关资料。共纳入130例肝移植受者,其中男性103例,女性27例,年龄(53.6±11.4)岁。分析感染新冠病毒严重程度、症状,比较不同临床特征受者转阴时间。结果130例受者中感染新冠病毒轻型121例(93.1%),中型5例(3.8%),重型3例(2.3%),危重型1例(0.8%)。在126例轻中型新冠病毒感染受者常见的症状为发热、乏力、咳嗽和肌痛。126例轻中型受者的转阴时间为3.0~29.0(范围)(10.1±4.5)d。126轻中型受者中肝移植术后时间≤12个月、口服霉酚酸酯类药物、口服甲泼尼龙的受者(n=28、53、10)转阴时间为(11.6±5.1)d、(11.4±5.4)d、(13.4±6.4)d,长于术后时间>12个月、未口服霉酚酸酯类药物、未口服甲泼尼龙的受者(n=98、73、116)转阴时间(9.7±4.2)d、(9.2±3.4)d、(9.8±4.2)d,差异均有统计学意义(均P<0.05)。有乏力、咳嗽症状的肝移植受者(n=71、59)转阴时间(11.0±5.1)d、(11.4±5.2)d,长于无乏力、咳嗽症状的肝移植受者(n=55、67)(9.0±3.3)d、(9.0±3.4)d,差异有统计学意义(t=2.64、2.92,P=0.009、0.004)。结论肝移植受者本轮感染新冠病毒主要为轻型和中型,轻中型受者常见症状为发热、乏力、咳嗽和肌痛,肝移植术后时间短、口服霉酚酸酯类药物和甲泼尼龙、有乏力、咳嗽的受者转阴时间延长。Objective To analyze the clinical characteristics of novel coronavirus(COVID-19)infection in liver transplant recipients.Methods Clinical data of 130 liver transplant recipients with COVID-19 infection followed in Hebei Medical University Third Hospital from November 2022 to January 2023 were retrospectively collected,including 103 males and 27 females,aged(53.6±11.4)years.The severity of COVID-19 infection,its clinical symptoms,and negative conversion time for each recipient were analyzed and compared.Results For the disease severity,121(93.1%)were mild,5(3.8%)were moderate,3(2.3%)were severe,and 1(0.8%)was critically severe.The most common symptoms in the 126 patients with mild to moderate COVID-19 infection were successively fever,fatigue,cough and myalgia,with a negative conversion time of(10.1±4.5)(3.0-29.0)d.In those who underwent transplantation less than 12 months(n=28),those who were taking mycophenolate mofetil(n=53)and those who were taking methylprednisolone(n=10),the negative conversion time was(11.6±5.1)d,(11.4±5.4)d,and(13.4±6.4)d,respectively,longer compared to those who underwent transplantation more than 12 months(9.7±4.2 d,n=98),and who were not taking mycophenolate mofetil(9.2±3.4 d,n=73)or methylprednisolone(9.8±4.2 d,n=116,all P<0.05).The negative conversion times were longer in recipients with symptoms(eg.fatigue and cough)than those in asymptomatic recipients(11.0±5.1 d vs.9.0±3.3 d,t=2.64,P=0.009,and 11.4±5.2 d vs.9.0±3.4 d,t=2.92,P=0.004).Conclusion The COVID-19 infection in liver transplant recipients was mainly mild and moderate.The most common symptoms are fever,fatigue,cough and myalgia.The short time(less than 12 months)after liver transplantation,oral mycophenolate mofetil and methylprednisolone,with symptoms(fatigue and cough)could be associated with a prolonged negative conversion time.

关 键 词：肝移植 新型冠状病毒 临床特征 

分 类 号：R657.3[医药卫生—外科学] R563.1[医药卫生—临床医学]