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新冠病毒肺炎患者肝功能检查异常及其影响因素——一项回顾性研究

Liver function test abnormalities in COVID-19 patients and factors affecting them - a retrospective study.

作者信息

Abdelrahman Mona Mohammed, Abdel-Baset Asmaa A, Younis Mustafa Adel, Mahmoud Mahmoud Gaber, Shafik Noha Saber

机构信息

Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Sohag University, Egypt.

Internal Medicine Department, Faculty of Medicine, Sohag University, Egypt.

出版信息

Clin Exp Hepatol. 2021 Sep;7(3):297-304. doi: 10.5114/ceh.2021.109225. Epub 2021 Sep 23.

Abstract

AIM OF THE STUDY

We aimed to study liver function test abnormalities in our COVID-19 patients and factors affecting them and to evaluate whether liver function test abnormalities are related to the severity of COVID-19.

MATERIAL AND METHODS

Our retrospective study included 118 patients who were SARS-CoV-2 positive. Their median age was 40 years. Fifty percent were male. Clinical and biochemical data were collected from patient records during the period from the start of June 2020 to the end of July 2020. Liver function test abnormalities included: alanine aminotransferase (ALT) > 40 U/l, aspartate aminotransferase (AST) > 40 U/l, serum albumin < 3.5 mg/dl, total bilirubin > 1.2 mg/dl, and international normalized ratio (INR) > 1.2.

RESULTS

Forty-four percent of COVID-19 patients had liver function test (LFT) abnormalities. In patients with severe SARS-CoV-2, AST, total bilirubin and INR levels were significantly higher than in patients with the non-severe disease. Levels of hemoglobin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum ferritin, D-dimer, and serum glucose were significantly higher in SARS-CoV-2 patients with LFT abnormalities than those with normal liver function.

CONCLUSIONS

LFT abnormalities are very common in SARS-CoV2 positive patients, especially those with the severe form. Levels of ESR, CRP, serum ferritin, and D-dimer were higher in COVID-19 patients with LFT abnormalities than those with normal LFT. High serum ferritin levels might be potential risk factors for LFT abnormalities.

摘要

研究目的

我们旨在研究新冠病毒肺炎患者的肝功能检查异常情况及其影响因素,并评估肝功能检查异常是否与新冠病毒肺炎的严重程度相关。

材料与方法

我们的回顾性研究纳入了118例新冠病毒核酸检测呈阳性的患者。他们的中位年龄为40岁。50%为男性。收集了2020年6月初至2020年7月底期间患者病历中的临床和生化数据。肝功能检查异常包括:丙氨酸氨基转移酶(ALT)>40 U/L、天冬氨酸氨基转移酶(AST)>40 U/L、血清白蛋白<3.5 mg/dl、总胆红素>1.2 mg/dl以及国际标准化比值(INR)>1.2。

结果

44%的新冠病毒肺炎患者存在肝功能检查(LFT)异常。在重症新冠病毒感染患者中,AST、总胆红素和INR水平显著高于非重症患者。肝功能检查异常的新冠病毒感染患者的血红蛋白、C反应蛋白(CRP)、红细胞沉降率(ESR)、血清铁蛋白、D-二聚体和血糖水平显著高于肝功能正常的患者。

结论

肝功能检查异常在新冠病毒核酸检测呈阳性的患者中非常常见,尤其是重症患者。肝功能检查异常的新冠病毒肺炎患者的ESR、CRP、血清铁蛋白和D-二聚体水平高于肝功能正常的患者。高血清铁蛋白水平可能是肝功能检查异常的潜在危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdd6/8527347/df2b2c5c6dd9/CEH-7-45180-g001.jpg

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