201例新型冠状病毒肺炎患者肝损害临床特征分析

龙丹; 秦凌辉; 高山

doi:10.3969/j.issn.1001-5256.2020.07.023

201例新型冠状病毒肺炎患者肝损害临床特征分析

DOI: 10.3969/j.issn.1001-5256.2020.07.023

1. 湖北文理学院附属医院襄阳市中心医院消化内科
2. 湖北文理学院附属医院襄阳市中心医院泌尿外科

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中图分类号: R575;R563.1
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- 出版日期: 2020-07-20

Clinical features of liver injury in patients with coronavirus disease 2019: An analysis of 201 cases

a. Department of Gastroenterology, b. Department of Urology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei 441021, China

摘要

摘要:
目的了解新型冠状病毒肺炎（COVID-19）患者肝损害特征,为临床诊治工作提供参考。方法收集2020年1月19日-3月5日湖北省襄阳市中心医院三院区收治的201例COVID-19患者的病历资料,分为非危重组（轻型/普通型,n=173）、危重组（重型/危重型,n=28） 2组,收集ALT、AST、TBil、DBil及Alb等指标。计量资料组间比较采用t检验;计数资料组间比较采用χ2检验;等级资料组间比较采用Wilcoxon秩和检验。结果 201例患者中37例（18. 4%）出现肝损害,危重组19例,非危重组18例,2组间肝损害发生率比较差异有统计学意义（67. 9%vs 10. 4%,χ2=52. 963,P <0. 05）。危重组肝损害患者与非危重组肝损害患者ALT和（或） AST水平异常时间（入院时和住院期间）情况比较差异有统计学意义（χ2=11. 906,P <0. 05）; 2组肝损害患者ALT和（或） AST水平升高情况比较差异有统计学意义（Z=-2. 869,P <0. 05）,大部分患者为轻中度肝损害。201例患者中胆红素升高者1例（TBil <2倍...
- 新型冠状病毒肺炎 /
- 肝损害 /
- 血清白蛋白
Abstract:
Objective To investigate the features of liver injury in patients with coronavirus disease 2019( COVID-19),and to provide a reference for clinical diagnosis and treatment. Methods Medical records were collected from 201 patients with COVID-19 who were admitted to Xiangyang Central Hospital from January 19 to March 5,2020,and these patients were divided into non-critical( mild/common type) group with 173 patients and critical( severe/critical type) group with 28 patients. The data on alanine aminotransferase( ALT),aspartate aminotransferase( AST),total bilirubin( TBil),direct bilirubin( DBil),and albumin( Alb) were collected. The t-test was used for comparison of normally distributed continuous data between groups,the chi-square test was used for comparison of categorical data between groups,and the Wilcoxon rank-sum test was used for comparison of ranked data between groups. Results Among the 201 patients,37( 18. 4%) had liver injury,with 19 in the critical group and 18 in the non-critical group,and there was a significant difference in the incidence rate of liver injury between the two groups( 67. 9% vs 10. 4%,χ2= 52. 963,P < 0. 05). There were significant differences between the 19 patients with liver injury in the critical group and the 18 patients with liver injury in the non-critical group in the duration of abnormal ALT and/or AST( on admission and during hospitalization)( χ2= 11. 906,P < 0. 05) and the increase in ALT and/or AST( Z =-2. 869,P < 0. 05),and most patients had mild or moderate liver injury. Among the 201 patients,only one patient had elevated bilirubin( TBil < 2 × upper limit of normal,mainly indirect bilirubin) and had non-critical liver injury. The critical group had a significantly lower level of Alb than the non-critical group( t =-8. 002,P < 0. 05). Among the 201 patients,75 had a reduction in Alb,among whom 50( 50/201,24. 9%) had a reduction on admission and 25( 25/201,12. 4%) had a reduction during hospitalization,and there were significant differences in Alb( t =-4. 967,P < 0. 05) and hypoalbuminemia( χ2= 26. 645,P < 0. 05) between the two periods of time. Conclusion Liver injury is relatively common in patients with COVID-19,mainly mild or moderate liver injury. There is a low incidence rate of abnormal bilirubin and a high incidence rate of the reduction in Alb. There are significant differences in the incidence rate and severity of liver injury between the crucial and non-critical patients. Alb level can be used as one of the indicators to evaluate and predict the severity of COVID-19 patients.
- coronavirus disease 2019 /
- liver injury /
- serum albumin

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参考文献(19)

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