实用医学杂志 ›› 2020, Vol. 36 ›› Issue (20): 2749-2752.doi: 10.3969/j.issn.1006⁃5725.2020.20.001

• 新型冠状病毒肺炎专栏 •    下一篇

普通型及重型新型冠状病毒肺炎患者病毒复制情况与肝脏损伤关系

刘召波 1 林栋栋 1 段钟平 2 胡中杰 3 殷继明 15 徐斌 4 栗光明 1
  

  1. 1首都医科大学附属北京佑安医院普通外科中心(北京 100069 2首都医科大学附属北京佑安医院疑难肝病及人工肝中心(北京 100069 3首都医科大学附属北京佑安医院重症肝病科(北京 100069 4首都医科大学附属北京佑安医院感染综合科(北京 1000695北京市肝病研究所(北京 100069
  • 出版日期:2020-10-20 发布日期:2020-11-20
  • 通讯作者: 栗光明 E⁃mail:liguangming917@163.com
  • 基金资助:
    北京医卫健康公益基金会(编号:LC19003

Relationship between replication of SARS⁃CoV⁃2 and liver injury in patients with moderate and severe type of coronavirus infectious disease 2019

LIU Zhaobo*LIN DongdongDUAN ZhongpingHU ZhongjieYIN JimingXU BinLI Guangming.    

  1. *Department of General SurgeryBeijing Youan HospitalCapital Medical UniversityBeijing 100069China
  • Online:2020-10-20 Published:2020-11-20
  • Contact: LI Guangming E⁃mail:liguangming917@163.com

摘要: 目的  分析普通型及重型新型冠状病毒肺炎(coronavirus infectious disease 2019COVID⁃19)患者病毒复制情况与肝脏损伤关系。 方法  纳入首都医科大学附属北京佑安医院收治的19例普通型及重型COVID⁃19患者,回顾性分析病毒核酸检测结果及肝脏酶学指标变化的关系。新型冠状病毒(SARS⁃CoV⁃2)核酸检测采用 RT⁃PCR 定性检测,肝脏酶学指标包括丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)及总胆红素(TBil)等指标。数据采用SPSS 22.0统计学软件进行分析。计数资料组间比较采用Fisher精确概率检验。结果  共纳入 19 例确诊患者,其中普通型患者 13 例,重型患者 9 例。19 例患者中 12 例患者(63.2 %)出现ALT升高,10例患者(52.6%)出现AST升高,2例患者(10.5 %)出现TBil升高,以上指标以一过性升高为主,出院时可降至正常。新型冠状病毒肺炎患者在核酸阳性期间与核酸转阴后ALTASTTBil升高比例差异无统计学意义(P0.05)。 结论  部分普通型及重型COVID⁃19患者会出现ALTASTTBil等肝脏生化指标水平的异常升高,但以一过性升高为主,SARS⁃CoV⁃2病毒复制与COVID⁃19患者的肝脏损伤未见明显直接关系。

关键词: 新型冠状病毒, 新型冠状病毒肺炎, 核酸, 肝功能, 肝损伤

Abstract: Objective To analyze the relationship between replication of 2019 novel coronavirus and liver
injury in patients with moderate and severe type of coronavirus infectious disease 2019.
MethodsNineteen patients
with coronavirus infectious disease 2019 were admitted to Beijing Youan Hospital
Capital Medical University.
Collect the results of novel coronavirus nucleic acids from respiratory specimens of patients such as sputum and
throat swabs. The changes of alanine aminotransferase
ALT),aspartate aminotransferase ASTand total
bilirubin
TBilindexes in patients with different clinical types were collected. The research data were analyzed
using SPSS 22.0 statistical software. Differences between groups were analyzed using Fisher′s exact chi⁃square test.
Results There were 13 cases of moderate type56.5%),6 cases of severe type26.1%),aged 31 to 71 years
the median age was 60 years7 cases of males36.8%),and 12 cases of female63.2%. ALT was increased in
12
63.2%%of 19 patientsAST was increased in 1052.6%),TBil was high in 210.5%),there was no statistical
difference in the proportion of ALT
AST and TBil during the period of nucleic acid positive and nucleic acid nega⁃
tive
P > 0.05. Conclusions Patients with moderate and severe types of COVID⁃19 will have abnormal elevation
of liver biochemical indexes
such as ALTASTTBIL and the main increase is transient. The direct toxicity of
novel coronavirus is less likely to cause liver damage.

Key words: SARS?CoV?2, COVID?19, nucleic acid, liver function, liver injury