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AP&T: 武汉市新冠肺炎患者肝损伤标志物与临床结局的关系

2020-08-31 MedSci原创 MedSci原创

新冠病毒主要引起呼吸道,肠道,肝脏和神经系统疾病。

        2019年12月开始,一种不明原因的肺炎病例出现在湖北省武汉市,并迅速传遍全国,成为国际关注的突发公共卫生事件,1月7日,中国疾病预防控制中心(CDC)在患者的拭子样本中检测到一种新型冠状病毒,后被命名为“新冠”病毒(COVID-19)。

        新冠病毒主要引起呼吸道,肠道,肝脏和神经系统疾病。一项研究表明患者,超过50%的COVID-19有不同程度的肝损伤,新冠肺炎患者的丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)均有不同程度的升高。而肝损伤与COVID-19的严重程度和死亡率有关,因此,本项研究旨在对武汉市新冠肺炎患者肝损伤标志物与临床结局的关系进行相关分析。

 

        研究人员收集了2020年1月3日至3月8日在武汉大学中南医院的675例COVID-19患者的临床资料,并进行回顾性分析。患者根据肝功能检测被分类为肝功能正常或异常以及肝损伤组。

 

        在675名患者中,有253名(37.5%)在住院期间肝功能异常,而52名(7.7%)有肝损伤。肝损伤患者和死亡患者中ALT和AST水平的动态变化更为显着。AST>正常上限(ULN)的三倍具有最高的死亡和机械通气风险。与AST水平正常的患者相比,死亡率和机械通气风险显着增加了19.27倍(95%置信区间[CI],4.89-75.97; P  <0.0001)和116.72倍(95%CI,31.58-431.46; P  <0.0001)。白细胞增加,淋巴细胞减少和女性性别与肝损伤独立相关。

 

        本项研究最后得出结论:肝功能的动态变化可能与COVID-19的严重程度和预后密切相关。肝损伤指数的增加与死亡率增加和机械通气的需要密切相关。

 

原始出处:

Haijun Huang. Et al. The association between markers of liver injury and clinical outcomes in patients with COVID‐19 in Wuhan. Alimentary Pharmacology and Therapeutics.2020.

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    学习

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    2020-08-31 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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