Qian Z P, Mei X, Zhang Y Y, Zou Y, Zhang Z G, Zhu H, Guo H Y, Liu Y, Ling Y, Zhang X Y, Wang J F, Lu H Z
Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Zhonghua Gan Zang Bing Za Zhi. 2020 Mar 20;28(3):229-233. doi: 10.3760/cma.j.cn501113-20200229-00076.
To summarize the clinical characteristics and liver biochemical parameters of 324 cases admitted with novel coronavirus pneumonia in Shanghai area. Clinical data and baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia admitted to the Shanghai Public Health Clinical Center from January 20, 2020 to February 24, 2020 were retrospectively analyzed. Patients were divided into two groups based on the status of illness: mild type (mild and typical) and severe type (severe and critical).The differences in clinical data and baseline liver biochemical parameters of the two groups were described and compared. The t-test and Wilcoxon rank-sum test were used for measurement data. The enumeration data were expressed by frequency and rate, and chi-square test was used. Of the 324 cases with novel coronavirus pneumonia, 26 were severe cases (8%), with median onset of 5 days, 20 cases were HBsAg positive (6.2%), and 70 cases (21.6%) with fatty liver, diagnosed with X-ray computed tomography. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), total bilirubin (TBil), albumin(ALB) and international normalized ratio (INR) of 324 cases at baseline were 27.86 ± 20.02 U/L, 29.33 ± 21.02 U/L, 59.93 ± 18.96 U / L, 39.00 ± 54.44 U/L, 9.46 ± 4.58 μmol / L, 40.64 ± 4.13 g / L and 1.02 ± 0.10. Of which, ALT was > than the upper limit of normal (> ULN), accounting for 15.7% (51/324). ALT and AST > ULN, accounting for 10.5% (34/324). ALP > ULN, accounting for 1.2% (4/324). ALP and GGT > ULN, accounting for 0.9% (3/324). INR > ULN was lowest, accounting for 0.6% (2/324). There were no statistically significant differences ( > 0.05) in ALT [(21.5 vs. 26) U / L, = 0.093], ALP [(57 vs.59) U/L, = 0.674], and GGT [(24 vs.28) U/L, = 0.101] between the severe group and the mild group. There were statistically significant differences in AST (23 U/L vs. 34 U/L, < 0.01), TBil (10.75 vs. 8.05 μmol / L, < 0.01), ALB (35.79 ± 4.75 vs. 41.07 ± 3.80 g/L, < 0.01), and INR (1.00 vs. 1.04, < 0.01). The baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia in Shanghai area was comparatively lower and the liverinjury degree was mild, and the bile duct cell damage was rare.
总结上海地区324例新型冠状病毒肺炎确诊病例的临床特征及肝脏生化指标。回顾性分析2020年1月20日至2月24日收治于上海市公共卫生临床中心的324例新型冠状病毒肺炎确诊病例的临床资料及基线肝脏生化指标。根据病情将患者分为两组：轻型（普通型和典型型）和重型（重型和危重型）。描述并比较两组患者的临床资料及基线肝脏生化指标的差异。计量资料采用t检验和Wilcoxon秩和检验。计数资料以频数和率表示，采用χ²检验。324例新型冠状病毒肺炎确诊病例中，重型26例（8%），发病中位数为5天，HBsAg阳性20例（6.2%），经X线计算机断层扫描诊断为脂肪肝70例（21.6%）。324例患者基线时谷丙转氨酶（ALT）、谷草转氨酶（AST）、碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GGT）、总胆红素（TBil）、白蛋白（ALB）及国际标准化比值（INR）分别为27.86±20.02 U/L、29.33±21.02 U/L、59.93±18.96 U/L、39.00±54.44 U/L、9.46±4.58 μmol/L、40.64±4.13 g/L及1.02±0.10。其中，ALT高于正常上限（>ULN）者占15.7%（51/324）。ALT和AST>ULN者占10.5%（34/324）。ALP>ULN者占1.2%（4/324）。ALP和GGT>ULN者占0.9%（3/324）。INR>ULN者最少，占0.6%（2/324）。重型组与轻型组的ALT[（21.5对26）U/L，P=0.093]、ALP[（57对59）U/L，P=0.674]及GGT[（24对28）U/L，P=0.101]差异无统计学意义（P>0.05）。AST（23 U/L对34 U/L，P<0.01）、TBil（10.75对8.05 μmol/L，P<0.01）、ALB（3
