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药物治疗与新冠病毒肺炎住院患者肝损伤发生率之间的关联

Association Between Drug Treatments and the Incidence of Liver Injury in Hospitalized Patients With COVID-19.

作者信息

Gao Suyu, Yang Qingqing, Wang Xuanxuan, Hu Wen, Lu Yun, Yang Kun, Jiang Qiaoli, Li Wenjing, Song Haibo, Sun Feng, Cheng Hong

机构信息

Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, China.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

出版信息

Front Pharmacol. 2022 Mar 21;13:799338. doi: 10.3389/fphar.2022.799338. eCollection 2022.

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) has led to the emergence of global health care. In this study, we aimed to explore the association between drug treatments and the incidence of drug-induced liver injury (DILI) in hospitalized patients with COVID-19. A retrospective study was conducted on 5113 COVID-19 patients in Hubei province, among which 395 incurred liver injury. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models. The results showed that COVID-19 patients who received antibiotics (HR 1.97, 95% CI: 1.55-2.51, < 0.001), antifungal agents (HR 3.10, 95% CI: 1.93-4.99, 0.001) and corticosteroids (HR 2.31, 95% CI: 1.80-2.96, < 0.001) had a higher risk of DILI compared to non-users. Special attention was given to the use of parenteral nutrition (HR 1.82, 95% CI: 1.31-2.52, < 0.001) and enteral nutrition (HR 2.71, 95% CI: 1.98-3.71, < 0.001), which were the risk factors for liver injury. In conclusion, this study suggests that the development of DILI in hospitalized patients with COVID-19 needs to be closely monitored, and the above-mentioned drug treatments may contribute to the risk of DILI.

摘要

2019年冠状病毒病(COVID-19)的爆发引发了全球医疗保健问题。在本研究中,我们旨在探讨COVID-19住院患者药物治疗与药物性肝损伤(DILI)发生率之间的关联。对湖北省5113例COVID-19患者进行了回顾性研究,其中395例发生肝损伤。通过Cox比例风险模型估计风险比(HRs)和95%置信区间(CIs)。结果显示,与未使用抗生素的COVID-19患者相比,使用抗生素的患者发生DILI的风险更高(HR 1.97,95% CI:1.55 - 2.51,<0.001),使用抗真菌药物的患者(HR 3.10,95% CI:1.93 - 4.99,<0.001)以及使用皮质类固醇的患者(HR 2.31,95% CI:1.80 - 2.96,<0.001)。特别关注了肠外营养(HR 1.82,95% CI:1.31 - 2.52,<0.001)和肠内营养(HR 2.71,95% CI:1.98 - 3.71,<0.001)的使用,它们是肝损伤的危险因素。总之,本研究表明,需要密切监测COVID-19住院患者DILI的发生情况,上述药物治疗可能会增加DILI的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6330/8978013/72cc4e8b9c2c/fphar-13-799338-g001.jpg

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