新型冠状病毒肺炎引起肝损伤的致病机制及病毒性肝炎肝硬化患者的防护策略

雷偲艺; 彭虹; 罗新华

doi:10.3969/j.issn.1001-5256.2020.07.037

新型冠状病毒肺炎引起肝损伤的致病机制及病毒性肝炎肝硬化患者的防护策略

DOI: 10.3969/j.issn.1001-5256.2020.07.037

1. 贵州医科大学附属医院感染科
2. 贵州省人民医院感染科

基金项目:

贵州省科技计划项目(QKHZC[2020]4Y002)；贵阳市科技计划项目(ZKXM[2020]4)；

详细信息

中图分类号: R563.1;R575
计量
- 文章访问数: 1215
- HTML全文浏览量: 66
- PDF下载量: 162
- 被引次数: 0
出版历程
- 出版日期: 2020-07-20

Pathogenic mechanism of liver injury caused by coronavirus disease 2019 and protective strategies for patients with viral hepatitis cirrhosis

1. Department of Infectious Diseases, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China
2. Department of Infectious Diseases, Guizhou Provincial People’s Hospital, Guiyang 550001, China

Research funding:

摘要

摘要:
新型冠状病毒肺炎（COVID-19）蔓延至全球多个国家,疫情期间部分患者表现出肝损伤。为了提高病毒性肝炎肝硬化患者对COVID-19的认识,加强疫情期间患者的自我防护和疾病管理,针对COVID-19引起肝损伤的致病机制及该类患者合理防疫、规范就医、科学用药等方面进行探讨和建议,以保证病毒性肝炎的常规管理,降低该类人群感染风险。
- 新型冠状病毒肺炎 /
- 肝损伤 /
- 肝硬化
Abstract:
Coronavirus disease 2019( COVID-19) has spread to many countries in the world,and some patients show liver injury during the epidemic of COVID-19. In order to improve the awareness of COVID-19 among patients with viral hepatitis cirrhosis and strengthen patients' self-protection and disease management,this article discusses the pathogenic mechanism of liver injury caused by COVID-19 and reasonable epidemic prevention,standardized medical treatment,and scientific medication for such patients and gives related recommendations,so as to ensure the routine management of viral hepatitis and reduce the risk of infection in such population.
- coronavirus disease 2019 /
- liver injury /
- liver cirrhosis

HTML全文

参考文献(29)

[1] Novel coronavirus pneumonia emergency response mechanism Epidemiology Group of China Center for Disease Control and Prevention.The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases(COVID-19)in China[J].Chin J Epidemiol,2020,41(2):145-151.(in Chinese)中国疾病预防控制中心新型冠状病毒肺炎应急响应机制流行病学组．新型冠状病毒肺炎流行病学特征分析[J]．中华流行病学杂志，2020,41(2):145-151．

[2]HUANG C,WANG Y,LI X,et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan,China[J].Lancet,2020,395(10223):497-506．

[3] General Office of National Health Commission of the People's Republic of China,General Office of State Administration of Traditional Chinese Medicine.Notice on the issuance of diagnosis and treatment protocol for COVID-19(trial version 7)[EB/OL].(2020-03-03).[2020-03-03].http://www.gov.cn/zhengce/zhengceku/2020-03/04/content_5486705.htm.(in Chinese)国家卫生健康委办公厅，国家中医药管理局办公室．关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知[EB/OL].(2020-03-03)[2020-03-03].http://www.gov.cn/zhengce/zhengceku/2020-03/04/content_5486705.htm．

[4] Official Website of National Health Commission of the People's Republic of China.Notice of the National Health Commission of the People's Republic of China on revising the English name of novel coronavirus pneumonia[EB/OL].(2020-02-22)[2020-03-5].http://www.gov.cn/zhengce/zhengceku/2020-02/22/content_5482019.htm.(in Chinese)国家卫生健康委员会官方网站．国家卫生健康委关于修订新型冠状病毒肺炎英文命名事宜的通知[EB/OL].(2020-02-22)[2020-03-5].http://www.gov.cn/zhengce/zhengceku/2020-02/22/content_5482019.htm．

[5] Health Emergency Response Office.The latest status of coronavirus disease 2019 up to 24 o'clock on March 6[R/OL].(2020-03-06)[2020-03-06].http://www.gov.cn/xinwen/2020-03/07/content_5488249.htm.(in Chinese)卫生应急办公室．截至3月06日24时新型冠状病毒肺炎疫情最新情况[R/OL].(2020-03-06)[2020-03-06].http://www.gov.cn/xinwen/2020-03/07/content_5488249.htm．

[6]Chinese Society of Hepatology,Chinese Medical Association.Chinese guidelines on the management of liver cirrhosis[J].J Clin Hepatol,2019,35(11):2408-2425.(in Chinese)中华医学会肝病学分会．肝硬化诊治指南[J]．临床肝胆病杂志，2019,35(11):2408-2425．

[7]KOCK RA,KARESH WB,VEAS F,et al.2019-n Co V in context:Lessons learned?[J].Lancet Planet Health,2020,4(3):e87-e88．

[8]ZHOU P,YANG XL,WANG XG,et al.A pneumonia outbreak associated with a new coronavirus of probable bat origin[J].Nature,2020,579(7798):270-273．

[9]TANG XL,WU CC,LI X,et al.On the origin and continuing evolution of SARS-Co V-2[J].Natl Sci Rev,2020.[Online ahead of print]

[10]ZHANG H,KANG ZJ,GONG HY,et al.The digestive system is a potential route of 2019-n Cov infection:A bioinformatics analysis based on single-cell transcriptomes[J].bioRxiv,2020.[Online ahead of print]

[11]DONOGHUE M,HSIEH F,BARONAS E,et al.A novel angiotensin-converting enzyme-related carboxypeptidase(ACE2)converts angiotensin I to angiotensin 1-9[J].Circ Res,2000,87(5):e1-e9．

[12] TIPNIS SR,HOOPER NM,HYDE R,et al.A human homolog of angiotensin-converting enzyme.Cloning and functional expression as a captopril-insensitive carboxypeptidase[J].J Biol Chem,2000,275(43):33238-33243．

[13]YANG Z,XU M,YI JQ,et al.The clinic characteristics and mechanism.If liver damage in patients with severe acute respiratory syndrome[J].Chin J Infect Dis,2003,21(4):13-15.(in Chinese)杨湛，许敏，易俊卿，等．严重急性呼吸综合征肝损伤的临床特征[J]．中华传染病杂志，2003,21(4):13-15．

[14] LU R,ZHAO X,LI J,et al.Genomic characterisation and epidemiology of 2019 novel coronavirus:Implications for virus origins and receptor binding[J].Lancet,2020,395(10224):565-574．

[15]Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association;Chinese Society of Infectious Diseases,Chinese Medical Association.Consensus on the diagnosis and treatment of cholestasis liver diseases(2015)[J].J Clin Hepatol,2015,31(12):1989-1999.(in Chinese)中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会．胆汁淤积性肝病诊断和治疗共识(2015)[J]．临床肝胆病杂志，2015,31(12):1989-1999．

[16] HUANG A,YANG XR,SUN HC,et al.Mechanisms and control measures of COVID-19 related liver injuries[J].Chin J Dig Surg,2020,19(3):248-250.(in Chinese)黄傲，杨欣荣，孙惠川，等．新型冠状病毒肺炎相关肝损伤的发生机制及防治措施[J]．中华消化外科杂志，2020,19(3):248-250．

[17]XUAN ZX,ZHANG GB,YE XL,et al.Cause analysis of liver injury in patients infected by novel coronavirus and suggestion of drug monitoring[J].Chin Pharmacol Bull,2020,36(4):591-592.(in Chinese)宣自学，张国兵，叶晓兰，等．新型冠状病毒肺炎患者肝损的原因分析[J]．中国药理学通报，2020,36(4):591-592．

[18]FAN Z,CHEN L,LI J,et al.Clinical features of COVID-19-related liver functional abnormality[J].Clin Gastroenterol Hepatol,2020,18(7):1561-1566．

[19]GUO WF,LIANG YY.Clinical effect of traditional Chinese medicine in treatment of viral hepatitis[J].Guide China Med,2011,9(31):184-185.(in Chinese)郭伟锋，梁彦彦．中药治疗病毒性肝炎的疗效观察[J]．中国医药指南，2011,9(31):184-185．

[20]XU Z,SHI L,WANG Y,et al.Pathological findings of COVID-19 associated with acute respiratory distress syndrome[J].Lancet Respir Med,2020,8(4):420-422．

[21]Chinese Society of Infectious Diseases,Chinese Medical Association;Chinese Society of Hepatology,Chinese Medical Association.Guidelines for the prevention and treatment of chronic hepatitis B(version2019)[J].J Clin Hepatol,2019,35(12):2648-2669.(in Chinese)中华医学会感染病学分会，中华医学会肝病学分会．慢性乙型肝炎防治指南(2019年版)[J]．临床肝胆病杂志，2019,35(12):2648-2669．

[22] Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.Guidelines for the prevention and treatment of hepatitis C(2019 version)[J].J Clin Hepatol,2019,35(12):2670-2686.(in Chinese)中华医学会肝病学分会，中华医学会感染病学分会．丙型肝炎防治指南(2019年版)[J]．临床肝胆病杂志，2019,35(12):2670-2686．

[23]SHI HM,LI R,CHEN H,et al.An excerpt of EASL clinical practice guidelines for the management of patients with decompensated cirrhosis(2018)[J].J Clin Hepatol,2018,34(8):1632-1638.(in Chinese)史慧敏，李瑞，陈红，等．《2018年欧洲肝病学会失代偿期肝硬化患者的管理临床实践指南》摘译[J]．临床肝胆病杂志，2018,34(8):1632-1638．

[24]Chinese Society of Hepatology,Chinese Society of Gastroenterology,Chinese Medical Association.Clinical guidelines on nutrition in endstage liver disease[J].J Clin Hepatol,2019,35(6):1222-1230.(in Chinese)中华医学会肝病学分会，中华医学会消化病学分会．终末期肝病临床营养指南[J]．临床肝胆病杂志，2019,35(6):1222-1230．

[25]ELFIKY AA.Anti-HCV,nucleotide inhibitors,repurposing against COVID-19[J].Life Sci,2020,248:117477．

[26] Chinese Society of Infectious Diseases,Chinese Medical Association,Expert Committee for Prevention and Management of Liver Inflammation.Prevention and management of liver inflammation:An expert consensus in China[J].Chin J Clin Infect Dis,2014,7(1):4-12.(in Chinese)中华医学会感染病学分会，肝脏炎症及其防治专家共识专家委员会．肝脏炎症及其防治专家共识[J]．中华临床感染病杂志，2014,7(1):4-12．

[27]ZHANG L,SCHUPPAN D.Traditional Chinese Medicine(TCM)for fibrotic liver disease:Hope and hype[J].J Hepatol,2014,61(1):166-168．

[28] Liver Failure and Artificial Liver Group,Branch of Infectious Diseases,Chinese Medical Association.Guideline for non-bioartificial liver support systems in treatment of liver failure:2016 update[J].Chin J Clin Infect Dis,2016,9(2):97-103.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝学组．非生物型人工肝治疗肝衰竭指南(2016年版)[J]．中华临床感染病杂志，2016,9(2):97-103．

[29]KEITH P,DAY M,PERKINS L,et al.A novel threatment approach to the novel coronavirus:An argument for the use of therapeutic plasma exchange for fulminant COVID-19[J].Crit Care,2020,24(1):128.

施引文献

资源附件(0)

访问统计