Fang Changquan, Xu Limin, Lu Jiancong, Li Yujun, Zhao Ziwen
The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China.
Department of Pulmonary and Critical Care Medicine, Huizhou Central People's Hospital, Huizhou, Guangdong, People's Republic of China.
Infect Drug Resist. 2025 Jun 28;18:3207-3217. doi: 10.2147/IDR.S535247. eCollection 2025.
Some patients with pneumonia exhibit liver function abnormalities. In this study, we aimed to elucidate the characteristics of liver function changes and the factors influencing liver injury in patients with pneumonia, providing a reference for clinical treatment.
The clinical data of patients with pneumonia admitted to three tertiary Grade A hospitals in Guangdong Province, China, from January 2020 to February 2025 were retrospectively collected. Changes in liver parameters and related influencing factors upon admission were analyzed.
Overall, 120 cases were included: 100 (83.3%) exhibited liver function abnormalities and 55 (45.8%) had liver injury. The incidence of liver function abnormalities and liver injury was significantly higher in the severe group than that in the mild group. Liver function abnormalities and injury associated with pneumonia were characterized by elevations in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) levels. AST and ALT levels exceeded three times the upper limit of normal (ULN) in 43 (35.8%) and 20 (16.7%) cases, respectively, while GGT exceeded twice the ULN in 25 (20.8%) cases. ALT (70 [47-115] vs 51 [26-73] U/L, = 0.002) and AST (122 [72-252] vs 52 [30-76] U/L, = 0.000) were significantly different between the severe and mild groups. Hepatocellular injury was the most common type of liver injury upon admission, followed by mixed and cholestatic types. Compared to patients without liver injury, those with liver injury had a higher prevalence of alcohol consumption history, dyspnea, higher pneumonia severity index scores, and longer hospital stays.
Patients with pneumonia, particularly severe cases, are prone to concurrent liver function abnormalities and liver injury. Liver injury, predominantly hepatocellular injury, was associated with factors such as alcohol consumption history, pneumonia severity, and elevated inflammatory responses, leading to prolonged hospital stays. Monitoring liver function may aid in early identification of severe cases.
部分肺炎患者存在肝功能异常。本研究旨在阐明肺炎患者肝功能变化特点及影响肝损伤的因素，为临床治疗提供参考。
回顾性收集2020年1月至2025年2月在中国广东省三家三级甲等医院住院的肺炎患者的临床资料。分析入院时肝脏参数变化及相关影响因素。
共纳入120例患者，其中100例（83.3%）出现肝功能异常，55例（45.8%）发生肝损伤。重度组肝功能异常和肝损伤的发生率显著高于轻度组。肺炎相关肝功能异常和损伤的特点是丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和γ-谷氨酰转移酶（GGT）水平升高。AST和ALT水平分别在43例（35.8%）和20例（16.7%）中超过正常上限（ULN）的三倍，而GGT在25例（20.8%）中超过ULN的两倍。重度组与轻度组的ALT（70[47 - 115] vs 51[26 - 73] U/L，P = 0.002）和AST（122[72 - 252] vs 52[30 - 76] U/L，P = 0.000）有显著差异。入院时肝细胞损伤是最常见的肝损伤类型，其次是混合型和胆汁淤积型。与无肝损伤患者相比，有肝损伤患者的饮酒史、呼吸困难患病率更高，肺炎严重指数评分更高，住院时间更长。
肺炎患者，尤其是重症患者，易并发肝功能异常和肝损伤。肝损伤以肝细胞损伤为主，与饮酒史、肺炎严重程度及炎症反应升高有关，导致住院时间延长。监测肝功能有助于早期识别重症病例。
