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111例新型冠状病毒肺炎老年患者肝功能变化特点

[Characteristics of liver function changes in 111 elderly patients with COVID-19 pneumonia].

作者信息

Xu L, Zhu B, Liang B Y, Liu J, Lu S S, Li S M, Zheng X

机构信息

Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 432200, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2022 May 20;30(5):527-533. doi: 10.3760/cma.j.cn501113-20200701-00362.

Abstract

To retrospectively analyze the characteristics and influencing factors of liver function changes in 111 elderly patients with COVID-19 pneumonia. 111 elderly patients with COVID-19 admitted to the Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 5 to March 3, 2020 were enrolled. According to the severity of disease and liver function condition, they were divided into severe group (=40), normal group (=71), abnormal liver function group (=86) and normal liver function group (=25). The indexes related to liver function changes [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT)] and related influencing factors were analyzed. Among 111 cases, 86 (77.5%) had abnormal liver function of varying degrees, and 28 (25.2%) had liver injury. The abnormal rates of TBil, AST, ALP and GGT were significantly higher in the severe group than normal group (<0.05). There were no significant differences in age, ribavirin, glucocorticoid and the application of lopinavir-ritonavir tablets between the abnormal liver function and the normal group (>0.05). The proportion of male was significantly higher in the abnormal liver function than normal liver function group (<0.05). Elderly COVID-19 patients have a higher proportion of abnormal liver function, and patients in the severe group are more likely to have higher level of TB, AST, ALP and GGT. The abnormal liver function may be related to the direct viral infection of the liver and the inflammatory immune response of the body after infection in elderly patients.

摘要

回顾性分析111例老年新型冠状病毒肺炎患者肝功能变化的特点及影响因素。选取2020年2月5日至3月3日在华中科技大学同济医学院附属协和医院感染科收治的111例老年新型冠状病毒肺炎患者。根据疾病严重程度及肝功能状况,将其分为重症组(n = 40)、轻症组(n = 71)、肝功能异常组(n = 86)和肝功能正常组(n = 25)。分析肝功能变化相关指标[总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)和γ-谷氨酰转肽酶(GGT)]及相关影响因素。111例患者中,86例(77.5%)出现不同程度肝功能异常,28例(25.2%)出现肝损伤。重症组TBil、AST、ALP和GGT异常率显著高于轻症组(P < 0.05)。肝功能异常组与肝功能正常组在年龄、利巴韦林、糖皮质激素及洛匹那韦-利托那韦片应用方面差异无统计学意义(P > 0.05)。肝功能异常组男性比例显著高于肝功能正常组(P < 0.05)。老年新型冠状病毒肺炎患者肝功能异常比例较高,重症组患者TB、AST、ALP和GGT水平更高。老年患者肝功能异常可能与病毒直接感染肝脏及感染后机体炎症免疫反应有关。

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