Liu C, Jiang Z C, Shao C X, Zhang H G, Yue H M, Chen Z H, Ma B Y, Liu W Y, Huang H H, Yang J, Wang Y, Liu H Y, Xu D, Wang J T, Yang J Y, Pan H Q, Zou S Q, Li F J, Lei J Q, Li X, He Q, Gu Y, Qi X L
COVID-19 study group, The First Hospital of Lanzhou University, Lanzhou 730000, China.
COVID-19 study group, Ankang Central Hospital, Ankang 725000, China.
Zhonghua Gan Zang Bing Za Zhi. 2020 Feb 20;28(2):107-111. doi: 10.3760/cma.j.issn.1007-3418.2020.02.003.
To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34 ~ 21.15) μmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31 ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) μmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) μmol/L, respectively. The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.
分析新型冠状病毒肺炎病例的临床特征，并初步探讨不同临床分型与肝损伤之间的关系。纳入2020年1月23日至2020年2月8日期间连续确诊并收治于7家定点医院的新型冠状病毒感染病例。根据国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案（试行第五版）》进行临床分型（轻型、普通型、重型、危重型）。采用SPSS19.0统计软件对研究数据进行分析。定量资料以中位数（四分位数间距）表示，定性资料以频数和率表示。共纳入32例符合纳入标准的确诊病例。其中轻型或普通型28例（87.50%），重型或危重型4例（12.50%）。4例（12.5%）合并1种基础疾病（支气管哮喘、冠心病、恶性肿瘤、慢性肾脏病），1例（3.13%）同时合并高血压和恶性肿瘤。实验室检查结果显示，全部研究对象谷丙转氨酶（ALT）、谷草转氨酶（AST）、白蛋白（ALB）、总胆红素（TBil）分别为26.98（16.88～46.09）U/L、24.75（18.71～31.79）U/L、39.00（36.20～44.20）g/L、16.40（11.34～21.15）μmol/L。轻型或普通型亚组ALT、AST、ALB、TBil分别为22.75（16.31～37.25）U/L、23.63（18.71～26.50）U/L、39.70（36.50～46.10）g/L、15.95（11.34～20.83）μmol/L。重型或危重型亚组ALT、AST、ALB、TBil分别为60.25（40.88～68.90）U/L、37.00（20.88～64.45）U/L、35.75（28.68～42.00）g/L、20.50（11.28～25.00）μmol/L。本多中心回顾性研究结果提示，新型冠状病毒肺炎合并肝损伤更可能是接受治疗的重型患者发生的药物不良反应和全身炎症所致。因此，对此类患者治疗期间应加强肝功能监测与评估。
